Robot-assisted laparoscopic ureteroureterostomy in a child with upper urinary tract duplication
- Authors: Kozlov Y.A.1,2,3, Poloyan S.S.1,3, Sapukhin E.V.1, Strashinsky A.S.1, Makarochkina M.V.1, Marchuk A.A.1, Rozhanskii A.P.3, Byrgazov A.A.1, Muravev S.A.3, Narkevich A.N.4,5
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Affiliations:
- Children’s Regional Clinical Hospital
- Irkutsk State Medical Academy of Postgraduate Education
- Irkutsk State Medical University
- South Ural State Medical University
- Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University
- Issue: Vol 14, No 2 (2024)
- Pages: 229-240
- Section: Case reports
- URL: https://journals.rcsi.science/2219-4061/article/view/263106
- DOI: https://doi.org/10.17816/psaic1773
- ID: 263106
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Abstract
Upper urinary tract duplication remains one of the most challenging pediatric urology conditions. Various operative methods are used in the treatment of children with this pathology; however, reoperation rate remains high. This study aimed to investigate a case of successful robot-assisted laparoscopic ureteroureterostomy and discuss the technical aspects of this procedure and review known series of robotic ureteroureterostomy. The authors retrospectively reviewed the medical history of a child with duplication of the right kidney, accompanied by reflux of urine into the lower segment collecting system. Surgical intervention was performed using robot-assisted technology. Using computed tomography and voiding cystourethrography, duplex kidney with vesicorenal reflux into the lower segment was diagnosed. The surgical technique used was ureteroureterostomy. The donor ureter was divided in the area of the intended anastomosis. Then, a surgical incision was made in the recipient ureter, the length of which was equal to the diameter of the donor ureter. After preparation of the ureters, an end-to-side anastomosis was performed. The operation was successfully performed without intraoperative difficulties or complications and lasted for 140 minutes. The robot installation time (docking time) was 20 minutes, and the main console time was thus 120 minutes. The patient started feeding on the same day after the operation. The drainage tube was removed after a control ultrasound examination on postoperative day 2. The stent remained in the recipient ureter until its removal 6 weeks after surgery. The duration of follow-up was 6 months. The patient was asymptomatic throughout the control period. Repeated ultrasound examination performed after surgery showed a decrease in the anteroposterior diameter of the lower segment pelvis to 5 mm. Blood flow in the upper and lower segments of the right kidney was not impaired. The advantages of the robotic approach, including improved instrument dexterity and 3D visualization, make it a safe and effective alternative to open or laparoscopic surgery in children.
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##article.viewOnOriginalSite##About the authors
Yury A. Kozlov
Children’s Regional Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education; Irkutsk State Medical University
Author for correspondence.
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
SPIN-code: 3682-0832
MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences
Russian Federation, Irkutsk; Irkutsk; IrkutskSimon S. Poloyan
Children’s Regional Clinical Hospital; Irkutsk State Medical University
Email: simonpoloyan@ya.ru
ORCID iD: 0000-0001-7042-6646
Russian Federation, Irkutsk; Irkutsk
Eduard V. Sapukhin
Children’s Regional Clinical Hospital
Email: sapukhin@yandex.ru
ORCID iD: 0000-0001-5470-7384
MD, Cand. Sci. (Medicine)
Russian Federation, IrkutskAleksey S. Strashinsky
Children’s Regional Clinical Hospital
Email: Leksus-642@yandex.ru
ORCID iD: 0000-0002-1911-4468
MD
Russian Federation, IrkutskMarina V. Makarochkina
Children’s Regional Clinical Hospital
Email: m.makarochkina@gmail.com
ORCID iD: 0000-0001-8295-6687
SPIN-code: 4600-4071
MD
Russian Federation, IrkutskAndrey A. Marchuk
Children’s Regional Clinical Hospital
Email: maa-ped20@yandex.ru
ORCID iD: 0000-0001-9767-0454
MD
Russian Federation, IrkutskAlexander P. Rozhanskii
Irkutsk State Medical University
Email: alexanderozhanski@mail.ru
ORCID iD: 0000-0001-7922-7600
MD
Russian Federation, IrkutskAnton A. Byrgazov
Children’s Regional Clinical Hospital
Email: byrgazov.ant-doc38@yandex.ru
ORCID iD: 0000-0002-9195-5480
MD
Russian Federation, IrkutskSergey A. Muravev
Irkutsk State Medical University
Email: muravev1999sergey@mail.ru
ORCID iD: 0000-0003-4731-7526
MD
Russian Federation, IrkutskArtem N. Narkevich
South Ural State Medical University; Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University
Email: narkevichart@gmail.com
ORCID iD: 0000-0002-1489-5058
MD, Dr. Sci. (Medicine), Assistant Prifessor
Russian Federation, Chelyabinsk; KrasnoyarskReferences
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