Pediatric robotic-assisted laparoscopic ipsilateral ureteroureterostomy in a duplicated collecting system

Abstract

Introduction and objective: Duplex renal collecting system is a common congenital anomaly in the pediatric population. The superior moiety ureter is often associated with an ectopic insertion. A common site of insertion is the urethra, which results in continuous incontinence. A novel repair for this abnormality is a robotic assisted laparoscopic ipsilateral ureteroureterostomy with end to side anastomosis. This teaching video will demonstrate positioning and operative technique for this procedure.

Patient and methods: This is the case of a 5-year-old girl who presented with lifelong continuous urinary incontinence. Workup revealed a duplicated collecting system with a functional superior moiety and ectopic ureter inserting into the urethra. A laparoscopic ipsilateral ureteroureterostomy was performed using a robotic surgical system.

Results: After docking the robotic surgical system, the duplicated collecting system was identified and an ipsilateral ureteroureterostomy was performed. The patient tolerated the procedure well and the ultrasound on follow up revealed no residual hydronephrosis.

Conclusion: The accompanying teaching video shows appropriate positioning and operative technique for a robotic-assisted laparoscopic ureteroureterostomy. This innovative and minimally invasive technique is a safe and feasible approach to repair a duplex collecting system with an ectopic ureter in the pediatric population.