Robotic-Assisted Reconstruction of the Transplant Ureter: A Minimally Invasive Option for a Rare Complication
1Urology, Upstate Medical University, Syracuse, NY, 2Surgery, Division of Transplantation, SUNY, Upstate Medical University, Syracuse, NY, 3Urology, SUNY, Upstate Medical University, Syracuse, NY
Meeting: 2022 American Transplant Congress
Abstract number: 1398
Keywords: Bacterial infection, Graft function, Kidney transplantation, Surgical complications
Topic: Clinical Science » Kidney » 41 - Kidney Technical
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: Ureteric stricture are rare after kidney transplants but nonetheless this complication requires reconstruction in the majority of cases to avoid graft dysfunction and/or failure. Our aim was to demonstrate the surgical technique of robotic reconstruction of transplant ureteric strictures using the da Vinci Xi robotic platform
*Methods: Between January 2020 and February 2021, 3 patients with transplant ureteral strictures were identified and treated with robotic-assisted laparoscopic repair. All ureteral strictures were confirmed with a preoperative antegrade nephrostogram (AGNG) through their nephrostomy tube and all received a cystogram. The patients’ demographics, ureteral characteristics, type of reconstruction, and outcomes are reported
*Results: All patients were diagnosed after evaluation for kidney dysfunction, as indicated by elevated creatinine and/or diminished eGFR. Average age was 41 years old and average BMI was 31.4. One patient had en-block kidney transplantation; 2 others had deceased donor kidney transplantation. While average cold ischemic time was 19.5 hrs, warm ischemic time was 63 min during kidney transplantation. All patients had double-J stents in their initial transplant surgery. All failed multiple interventional radiology attempts of stricture repair. The average stricture length was 1.7 cm and the locations were in the distal ureter in 2 patients and mid ureter in 1 patient. One patient required a pyelo-vesicostomy, while 2 required a side-to-side ureteropyeloplasty. Post-operatively, the mean length of hospitalization was 1.3 days. No surgical site infections have occurred. Foley catheters remained in place for 8 days and stents for 28 days, on average. No strictures or delayed leaks have been identified to date
*Conclusions: The robot-assisted approach to transplant ureter reconstruction using a side-to-side neoureterocystotomy is technically safe and successful. In comparison to an open approach, the robotic approach offers significant advantages to both the patient, through a minimally invasive technique, and to the surgeon who is experienced with robotic surgery and reconstructive surgery
To cite this abstract in AMA style:
Popovic A, Hanlon M, Iskhagi S, Saidi R, Blakely S, Shahbazov R. Robotic-Assisted Reconstruction of the Transplant Ureter: A Minimally Invasive Option for a Rare Complication [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/robotic-assisted-reconstruction-of-the-transplant-ureter-a-minimally-invasive-option-for-a-rare-complication/. Accessed May 28, 2025.« Back to 2022 American Transplant Congress