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• W3022970570 abstract "You have accessJournal of UrologyTransplant, Misc GU Cancers & Bladder Reconstruction (non-cancer) (V11)1 Apr 2020V11-07 ROBOTIC-ASSITED TRANSPLANTED URETERAL STRICTURE MANAGEMENT Begoña Etcheverry Giadrosich*, Andreu Alabat Roca, Lluis Riera Canals, Maria Fiol Riera, Sergi Beato Garcia, and Francesc Vigués Julià Begoña Etcheverry Giadrosich*Begoña Etcheverry Giadrosich* More articles by this author , Andreu Alabat RocaAndreu Alabat Roca More articles by this author , Lluis Riera CanalsLluis Riera Canals More articles by this author , Maria Fiol RieraMaria Fiol Riera More articles by this author , Sergi Beato GarciaSergi Beato Garcia More articles by this author , and Francesc Vigués JuliàFrancesc Vigués Julià More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000945.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary tract complications are relevant source of morbidity and mortality after kidney transplantation (KT). Ureteral stricture (US) is the most common urinary complications (0,6%-10,5%). The aim of this video is to present a minimally invasive technique using Da Vinci Robot for the ureteral reimplantation. METHODS: We present three patients with distal US after KT managed by a robot-assisted ureter reimplantation. The first case was a 29 years old man, transplanted on 2018. A Lich-Gregoire extravesical anastomosis was performed, a ureteral stent was placed. At third month he presented renal failure. The second one, was a 59 years old man, he received KT on 1984. A Politano-Lead better intravesical anastomosis was performed, without ureteral stent. He presented worsening renal function after 35 years. The third one was a 67 years old man, transplanted on 2018. A Lich-Gregoire extravesical anastomosis was performed and ureteral stent was placed. He presented an obstructive pyelonephritis two months later. In the three cases an ultrasound demonstrated hydronephrosis, needing the placement of a nephrostomy. The anterograde pyelography showed a distal US. The third patient was treated unsuccessfully with percutaneous balloon dilation. We present three robotic ureterovesical reimplantation after kidney transplant. We present two different ways to visualization the ureter. In the first patient serum through nephrostomy tube was instilled. In the others 2 patients, indocyanine green through nephrostomy tube was instilled and visualized using Firefly system. The ureteral end is spatulated and the anastomosis to the bladder is done with monocryl 4/0 suture. In the first and second patient, an ureterovesical reimplantation according to the Lich-Gregoir technique was performed. We left a 4,8 Ch, 12cm in the first and third patient. RESULTS: Overall, the mean operative time was 149 minutes. Median estimated blood loss was about 70mL. Anterograde pyelography showed good pass of the contrast medium through the ureter until the bladder in the three patients. Serum creatinine value and ultrasound remained stable, with a median follow-up of 7 months.The nephrostomy tube was removed within 2 months.The patients were discharged within 5 days. There were no recurrences neither urological complications. CONCLUSIONS: Minimal invasive Robotic approach for the management of ureteral stricture after kidney transplantation is safe and helpful. The instillation of saline solution and/or indocyanine green may assist with identification of the ureter and the stricture. Source of Funding:. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1016-e1016 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Begoña Etcheverry Giadrosich* More articles by this author Andreu Alabat Roca More articles by this author Lluis Riera Canals More articles by this author Maria Fiol Riera More articles by this author Sergi Beato Garcia More articles by this author Francesc Vigués Julià More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W3022970570 date "2020-04-01" @default.
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• W3022970570 title "V11-07 ROBOTIC-ASSITED TRANSPLANTED URETERAL STRICTURE MANAGEMENT" @default.
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