To present a novel surgical concept utilizing preoperative imaging to estimate length needed for ileal segment. This enables robotic ileal interposition to be completed with only one position change during surgery.
The index patient is a 69 year old female with a history of stage 3B cervical cancer treated with chemotherapy and radiation 5 years prior to presentation. The patient subsequently developed a long segment stricture of the left ureter, which had been managed with ureteral stents. The patient decided to proceed with robotic ileal ureter for management of her ureteral stricture disease. We utilized preoperative CT scan measurements to estimate length needed for ileal segment. This eliminated the need for multiple position changes during surgery.
The patient tolerated the procedure well. Estimated blood loss was 50 cc. Kidney ultrasound at 1 month post-op revealed no hydronephrosis. Renal scan at 12 months post-op revealed stable function at 32% and t ½ of 3 minutes. The patient reports she is doing well and is pain free at this time.
Robotic ileal interposition is a technically feasible procedure with good functional outcomes. By using preoperative imaging to estimate length needed for ileal segment, only one position change is needed during surgery.
Urology. 2017 Mar 01 [Epub ahead of print]
Adam S Baumgarten, Bhavik B Shah, Trushar Patel, Lucas R Wiegand
University of South Florida, Department of Urology., University of South Florida, Department of Urology. Electronic address: .