Robot-assisted extravesical ureteral reimplantation for vesicoureteral reflux

Kozlov YuA, Poloyan SS, Sapukhin EV, et al. . Robot-assisted extravesical ureteral reimplantation for vesicoureteral reflux. Endoscopic Surgery. 2024;30(1):60‑66. (In Russ.)
https://doi.org/10.17116/endoskop20243001160

Подписка 2026 Эндоскопическая хирургия (Endoscopic Surgery)

Использование инфографики авторами научных работ

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BACKGROUND

In the present study, we present a case report on the treatment of a patient with vesicoureteral reflux using the Lich-Gregoir robot-assisted operation and report its short-term results.

MATERIAL AND METHODS

In this study, we report a clinical case of treatment of grade 3 vesicoureteral reflux in the right ureter in a 10-year-old girl, implemented using robot-assisted technology in the Irkutsk State Regional Children’s Clinical Hospital. The patient underwent robot-assisted extravesical ureteral reimplantation (REVUR), performed in the manner of the Lich-Gregoir operation using the Versius surgical robot manufactured by CMR (UK). The technical details of the operation consisted in the mobilization of the ureter and the formation of a muscle tunnel by cutting the detrusor. The length of the detrusorotomy was approximately 35 mm. The ureter rose up and fit into the formed tunnel. Detrusororrhaphy over it was performed using separate absorbable PDSII 4/0 sutures. Postoperative follow-up included a clinical assessment as well as an x-ray examination of the bladder 3 months after surgery.

RESULTS

The total duration of the operation was 135 minutes. Of these, it took 10 minutes to dock the robot and 125 minutes to perform the main stage of the surgical intervention — ureter reimplantation. During the procedure, no intraoperative complications were recorded in the form of damage to the bladder mucosa or injury to nearby anatomical structures. The length of stay in the hospital was 6 days. The patient was followed up for 3 months. The ureteral stent was removed 1 month after the operation. To assess the effectiveness of the treatment, voiding cystography was performed, which demonstrated the disappearance of vesicoureteral reflux on the side where the operation was performed.

CONCLUSION

The Lich-Gregoir robotic procedure is a safe and effective procedure designed to correct vesicoureteral reflux. This method requires the accumulation of patients and a qualitative assessment of the surgical intervention performed in order to more accurately and comprehensively determine the role of the robotic approach in the treatment of vesicoureteral reflux in children.

Keywords:

vesicoureteral reflux

ureteral reimplantation

robot-assisted surgery

children

Authors:

Kozlov Yu.A.

Children’s Regional Clinical Hospital;
Irkutsk State Medical Academy of Postgraduate Education;
Irkutsk State Medical University

ORCID: 0000-0003-2313-897X

Poloyan S.S.

Children’s Regional Clinical Hospital;
Irkutsk State Medical University

ORCID: 0000-0001-7042-6646

Sapukhin E.V.

Children’s Regional Clinical Hospital

ORCID: 0000-0001-5470-7384

Strashinsky A.S.

Children’s Regional Clinical Hospital

ORCID: 0000-0002-1911-4468

Yakovchenko S.N.

Irkutsk State Regional Children’s Clinical Hospital

ORCID: 0000-0003-3193-6410

Marchuk A.A.

Children’s Regional Clinical Hospital

ORCID: 0000-0001-9767-0454

Rozhanski A.P.

Irkutsk State Medical University of the Ministry of Health of Russia

ORCID: 0000-0001-7922-7600

Romanovich E.S.

Irkutsk State Medical University

ORCID: 0009-0005-1795-9386

Received:

26.07.2023

Accepted:

26.09.2023

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