Robot-Assisted Laparoscopic Ureteral Reimplantation

Clinical indications for ureteral reconstruction include strictures, trauma (often iatrogenic), vesicoureteral reflux (VUR), fistulas and malignancy. Traditional open surgery used to be the gold standard for ureteral reimplantation with good long-term results (success rates over 90%) (Campbell’s urology, Philadelphia, p. 2347, 2003; Stief et al. Br J Urol 91:138–142, 2003; Ahn and Laughlin, Urology 58:184–187, 2001). However, in the last years with further distribution of Robot-assisted surgery in Urology, there is a significant trend towards the use of the robot for reconstructive surgery, such as ureteral reimplantation, also for children (Passoni and Peters, J. Endourol 34; S31–43, 2020). Nevertheless, the basic principles of open surgery have not changed: Short ureteral defects can be managed by uretero-ureterostomy or ureteroneocystostomy. Longer defects require complex procedures such as psoas hitch ureteral reimplantation often combined with a Boari-flap. For all these techniques the robot-assisted approach enables to perform the surgery in a minimally invasive fashion Drain et al. Urol Clin North Am 48; 91–101; 2021).