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• W2078751042 abstract "You have accessJournal of UrologyPediatrics1 Apr 2015V7-11 ROBOT-ASSISTED REPAIR OF A CIRCUMCAVAL URETER IN A CHILD Hubert Swana, Diego Aguilar, Alberto DuBoy, and Mark Rich Hubert SwanaHubert Swana More articles by this author , Diego AguilarDiego Aguilar More articles by this author , Alberto DuBoyAlberto DuBoy More articles by this author , and Mark RichMark Rich More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1942AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Circumcaval Ureter or retrocaval ureter is a rare congenital venous anomaly that results from the posterior cardinal vein persisting as the renal segment of the inferior vena cava (IVC) during development. Ureteral compression by the IVC, psoas muscle and vertebrae results in progressive ureteral obstruction and hydronephrosis. Patients present with flank pain or abdominal pain in the third or fourth decades of life with rare cases occuring in children. We present a video demonstrating a Robot-assisted Pyeloureterostomy ( RAPU) in a child presenting with a symptomatic circumcaval ureter. METHODS An 11 year-old male presented with intermittent right flank and abdominal pain. Ultrasound revealed right hydronephrosis and a dilated proximal ureter with an “S-shaped” deformity. Nuclear renal scan was suspicious for right renal obstruction. Cystoscopy and retrograde ureteropyelography again demonstrated proximal ureteral dilation and an “S-shaped” deformity of the ureter. A double-J stent was placed. Laparoscopic robot-assisted pyeloureterostomy (RAPU) was performed. A 12 mm umbilical camera port, two 8 mm robotic instrument ports and one 10mm assistant port were placed. The colon was reflected medially. The renal pelvis was identified and the proximal ureter was dissected as it coursed under the inferior vena cava (IVC). The segment of ureter that passed under the IVC was transected and partially excised. This partially excised ureteral segment served as a handle to minimize manipulation during anastomosis. Interrupted 5-0 polygalactin sutures were used to anastomose the ureter anterior to the IVC. A Jackson-Pratt drain was left in place. RESULTS Console time was 180 minutes. Blood loss was minimal. The patient tolerated the procedure well and no complications occurred. The patient was ready for discharge on post-operative day two. The stent was removed six weeks later. At the three month follow-up the patient was asymptomatic and the hydronephrosis had improved significantly. CONCLUSIONS Symptomatic circumcaval ureter is uncommon in children. With a careful characterization of the anatomy circumcaval ureter is well suited to minimally-invasive repair. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e662 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hubert Swana More articles by this author Diego Aguilar More articles by this author Alberto DuBoy More articles by this author Mark Rich More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2078751042 title "V7-11 ROBOT-ASSISTED REPAIR OF A CIRCUMCAVAL URETER IN A CHILD" @default.
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