Intentional Omission of Ureteral Stents during Robotic Assisted Intracorporeal Uretero-Enteric Anastomosis: is It Safe and Feasible?

To describe the surgical technique we use to perform a stentless intracorporeal uretero-enteric anastomosis and to determine the outcomes in this initial series.

We performed a retrospective review of a prospective database of all patients undergoing robotic assisted intracorporeal urinary diversion with stentless uretero-enteric anastomosis between March 2014 and July 2016. Diversions were performed either at the time of robotic assisted laparoscopic cystectomy for bladder cancer or urinary diversion for other indications.

A total of 10 patients underwent implantation of 20 ureters into the intestine via a robotic assisted approach with intentional omission of stents. Median BMI was 29.57 (1st quartile 23.68, 3rd quartile 34.69). Median ASA score was 3 (range 2-3). Seven patients had intracorporeal ileal conduit reconstruction and three patients had an intracorporeal neobladder creation. There were no patients that develop a stricture of the ureter nor did any patient develop a leak at the uretero-enteric anastomosis. All patients had normal serum creatinine at least 4 weeks after surgery and all patients had follow up computed tomography of the kidneys which were normal. The median follow-up was 8 months (1(st) quartile = 3 months, 3(rd) quartile = 17 months).

Robotic Intracorporeal urinary diversion with intentional omission of ureteral stents is a safe and feasible option when establishing continuity of the genitourinary and gastrointestinal tracts.

Urology. 2017 Jan 19 [Epub ahead of print]

Wei Phin Tan, Patrick Whelan, Leslie Deane

Department of Urology Rush University Medical Center, Chicago. Electronic address: ., Department of Urology Rush University Medical Center, Chicago.