Investig Clin Urol.
2023 Jul;64(4):373-379. 10.4111/icu.20230005.
Outcomes of single-port robotic ureteral reconstruction using the da Vinci SP® system
- Affiliations
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- 1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
- 2Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- 3Department of Urology, Konyang University College of Medicine, Daejeon, Korea
- 4Department of Urology, Chosun University School of Medicine, Gwangju, Korea
- KMID: 2544036
- DOI: http://doi.org/10.4111/icu.20230005
Abstract
- Purpose
The da Vinci SP® robotic system enables three double-jointed wristed instruments and a fully wristed three-dimensional camera to be placed through a single port. This study presents our experience with robot-assisted ureteral reconstruction using the SP system and reports its outcomes.
Materials and Methods
Between December 2018 and April 2022, a single surgeon performed robotic ureteral reconstruction using the SP system in 39 patients: 18 underwent pyeloplasty and 21 received ureteral reimplantation. Demographic and perioperative patient data were collected and analyzed. Radiographic and symptomatic improvements were assessed 3 months after surgery.
Results
In pyeloplasty group, 12 patients (66.7%) were female and two patients (11.1%) had undergone previous surgery for ureteral obstruction. The median operative time was 152 minutes, the median blood loss was 8 mL, and the median length of stay in hospital was 3 days. There was one case of a complication involving postoperative percutaneous nephrostomy (PCN). In ureteral reimplantation group, 19 patients (90.5%) were female and ten patients (47.6%) had undergone gynecological surgery that caused ureteral obstruction. The median operative time was 152 minutes, the median blood loss was 10 mL, and the median length of stay in hospital was 4 days. We observed one case of open conversion and two cases of complications (colonic serosal tearing and postoperative PCN after ileal ureter replacement). The radiographic results and symptoms successfully improved following both surgeries.
Conclusions
Despite adhesion-related complications, the SP system appears to be safe and effective for use in robot-assisted ureteral reconstruction.
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