Robot-assisted extravesical ureteral reimplantation for vesicoureteral reflux

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

Robot-assisted extravesical ureteral reimplantation for vesicoureteral reflux

Authors:

Kozlov Yu.A., Poloyan S.S., Sapukhin E.V., Strashinsky A.S., Yakovchenko S.N., Marchuk A.A., Rozhanski A.P., Romanovich E.S.

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Journal: Endoscopic Surgery. 2024;30(1): 60‑66

DOI: 10.17116/endoskop20243001160

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To cite this article:

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

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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

List of references:

Dubrov VI, Sizonov VV, Kagantsov IM, Negmatova KN, Bondarenko S.G. Predicting the results of a single endoscopic correction of vesicoureteral reflux using hyaluronic acid dextranomer. Selection of the optimal predictive model. Vestnik Urologii. 2021;2:45-55. (In Russ.).
Kovarsky SL, Menovshchikova LB, Sklyarova TA, Zakharov AI, Nikolaev SN, Tekotov AN. Endoscopic correction of vesicoureteral reflux in children and prevention of possible complications. Rossiiskii vestnik detskoi khirurgii, anesteziologii i reanimatologii. 2021;S:68. (In Russ.).
Dubrov VI, Bondarenko SG, Kagantsov IM. Modified unilateral laparoscopic extravesical antireflux surgery. Rossiiskii vestnik detskoi khirurgii, anesteziologii i reanimatologii. 2018;2:26-34. (In Russ.).
Chen CJ, Peters CA. Robotic Assisted Surgery in Pediatric Urology: Current Status and Future Directions. Front Pediatr. 2019;7:90.
Gundetti MS, Boysen WR, Shah A. Robot-assisted Laparoscopic Extravesical Ureteral Reimplantation: Technique Modifications Contribute to Optimized Outcomes. Eur Urol. 2016;70(5):818-823.
Schomburg JL, Haberman K, Willihnganz-Lawson KH, Shukla AR. Robot-assisted laparoscopic ureteral reimplantation: a single surgeon comparison to open surgery. J Pediatr Urol. 2014;10(5):875-879.
Peters CA. Robotically assisted surgery in pediatric urology. Urol Clin North Am. 2004;31(4):743-752.
Cundy TP, Harley SJD, Marcus HJ, Hughes-Hallett A, Khurana S. Global trends in paediatric robot-assisted urological surgery: a bibliometric and Progressive Scholarly Acceptance analysis. J Robot Surg. 2018;12(1):109-115.
Baek M, Koh CJ. Lessons learned over a decade of pediatric robotic ureteral reimplantation. Investig Clin Urol. 2017;58(1):3-11.
Sahadev R, Spencer K, Srinivasan AK, Long CJ, Shukla AR. The Robot-Assisted Extravesical Anti-reflux Surgery: How We Overcame the Learning Curve. Front Pediatr. 2019;7:93.
Boysen WR, Ellison JS, Kim C, Koh CJ, Noh P, Whittam B, Palmer B, Shukla A, Kirsch A, Gundeti MS. Multi-Institutional Review of Outcomes and Complications of Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation for Treatment of Primary Vesicoureteral Reflux in Children. J Urol. 2017;197(6):1555-1561.
Akhavan A, Avery D, Lendvay TS. Robot-assisted extravesical ureteral reimplantation: outcomes and conclusions from 78 ureters. J Pediatr Urol. 2014;10(5):864-868.
Qureshi AH, Ajayi O, Schwaderer AL, Hains DS. Decreased Identification of Vesicoureteral Reflux: A Cautionary Tale. Front Pediatr. 2017;5:175.
Peters CA, Woo R. Intravesical robotically assisted bilateral ureteral reimplantation. J Endourol. 2005;19(6):618-621; discussion 621-622.
Marchini GS, Hong YK, Minnillo BJ, Diamond DA, Houck CS, Meier PM, Passerotti CC, Kaplan JR, Retik AB, Nguyen HT. Robotic assisted laparoscopic ureteral reimplantation in children: case matched comparative study with open surgical approach. J Urol. 2011;185(5):1870-1875.
Casale P, Patel RP, Kolon TF. Nerve sparing robotic extravesical ureteral reimplantation. J Urol. 2008;179(5):1987-1989; discussion 1990.
Silay MS, Baek M, Koh CJ. Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation in Children: Top-Down Suturing Technique Without Stent Placement. J Endourol. 2015;29(8):864-866.
Boysen WR, Akhavan A, Ko J, Ellison JS, Lendvay TS, Huang J, Garcia-Roig M, Kirsch A, Koh CJ, Schulte M, Noh P, Monn MF, Whittam B, Kawal T, Shukla A, Srinivasan A, Gundeti MS. Prospective multicenter study on robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV): Outcomes and complications. J Pediatr Urol. 2018;14(3):262.e1-262.e6.
Elizondo RA, Au JK, Song SH, Huang GO, Zhang W, Zhu H, Janzen N, Seth A, Roth DR, Tu DT, Koh CJ. Open versus robot-assisted laparoscopic ureteral reimplantation: Hospital charges analysis and outcomes at a single institution. J Pediatr Surg. 2020;S0022-3468(19)30901-7.
Esposito C, Varlet F, Riquelme MA, Fourcade L, Valla JS, Ballouhey Q, Scalabre A, Escolino M. Postoperative bladder dysfunction and outcomes after minimally invasive extravesical ureteric reimplantation in children using a laparoscopic and a robot-assisted approach: results of a multicentre international survey. BJU Int. 2019;124(5):820-827.
Esposito C, Masieri L, Fourcade L, Ballouhey Q, Varlet F, Scalabre A, Castagnetti M, El Ghoneimi A, Escolino M. Pediatric robot-assisted extravesical ureteral reimplantation (REVUR) in simple and complex ureter anatomy: Report of a multicenter experience. J Pediatr Urol. 2023;19(1):136.e1-136.e7.

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