Robot-Assisted Laparoscopic Ureteral Reconstruction: а systematic review of literature

Abstract

IntroductionTo review the literature, as well as to analyze and compare available data on robot-assisted laparoscopic (RAL) surgery versus open surgery, carried out in ureteral reconstructions in terms of different surgical characteristics.Materials and methodsEligible studies, published between 1997 and July 2016, were retrieved through MEDLINE by applying predetermined inclusion and exclusion criteria with the English language restriction. Publications on RAL surgeries, carried out in different ureteral reconstructions and of any study design, including case series and comparative studies, were included. The study was performed in accordance with the PRISMA statement.ResultsA total of 12 retrospective studies (case series and comparative studies) met the systematic review selection criteria involving 245 RAL and 76 open ureteral surgery cases. Main indications for ureter reconstruction were strictures, tumors and injuries. The individual results of comparative studies revealed that the EBL was statistically significantly lower for RAL than for open surgery. As for operation time, length of hospital stay and follow-up time, the data was contradictory. The rate of recurrent stricture in RAL and open groups was similar: -9.0%. The meta-analysis of three comparative studies confirmed that patients lose statistically significantly less blood in RAL, compared to open surgery.ConclusionsThe analysis of limited data available shows that robot-assisted laparoscopic ureteral reconstruction is a safe and effective minimally invasive technique with high cure rates similar to those of the conventional open approach and, with favorable safety profile. Future well-designed randomized controlled trials are required to strengthen our findings.

2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

“…In cases where the IUTI reconstruction is postponed, the subsequent referral of the patient to a center with expertise in minimally invasive robotic urologic surgery shows excellent outcomes [ 133 , 134 ]. Even catastrophic iatrogenic IUTI can be managed successfully if prompt recognition and successful management are adopted [ 135 ].…”

Efficacy of Robot-Assisted Ureteroureterostomy in Patients with Complex Ureteral Stricture after Ureteroscopic Lithotripsy

“…However, endoscopic treatment, considered the least-invasive option, may have reduced success rates when URSL is the underlying cause of US [6]. Traditional surgical techniques, including open ureteral reimplantation and laparoscopic ureteral reconstruction, have been employed to manage complex or recurrent US [7,8], although they have inherent limitations, including extended hospital stays, increased postoperative pain, and prolonged recovery periods [9,10]. Consequently, robot-assisted 2 of 11 ureteral reconstruction has emerged as a viable option with favorable outcomes because of the advantages of three-dimensional vision, magnified visibility, and adjunct near-infrared fluorescence (NIRF) imaging [9][10][11][12].…”