The management of a ureteral orifice injury occurring during robotic radical prostatectomy (RARP) represents a challenge for urologists. Several techniques have been proposed to treat an intraoperative injury, but intraoperative positioning of a DJ stent represents the most common treatment in cases of a partial injury of the ureteral orifice. We present a technique to ensure the successful outcome in cases of a partial detachment of the ureter during RARP. When the orifice is identified after the incision of the bladder neck and it appears very close to the anastomosis line setting up a partial detachment of the ureter, before implanting a DJ stent, one tip could be to perform a small incision of the anterior wall of the orifice to spatulate it and then proceeding to a short slip of the ureter: the eversion of the mucosa - creating a sort of "folded shirt cuff"- allows the fixation of the ureter to the bladder wall. We successfully performed this technique in two cases of RARP.

How to manage a partial detachment of the ureter - too close to the anastomosis line- during robotic radical prostatectomy?

Dal Moro, Fabrizio
;
Goffo, Federico;Ferraioli, Giordana;Zaborra, Carlotta;
2020

Abstract

The management of a ureteral orifice injury occurring during robotic radical prostatectomy (RARP) represents a challenge for urologists. Several techniques have been proposed to treat an intraoperative injury, but intraoperative positioning of a DJ stent represents the most common treatment in cases of a partial injury of the ureteral orifice. We present a technique to ensure the successful outcome in cases of a partial detachment of the ureter during RARP. When the orifice is identified after the incision of the bladder neck and it appears very close to the anastomosis line setting up a partial detachment of the ureter, before implanting a DJ stent, one tip could be to perform a small incision of the anterior wall of the orifice to spatulate it and then proceeding to a short slip of the ureter: the eversion of the mucosa - creating a sort of "folded shirt cuff"- allows the fixation of the ureter to the bladder wall. We successfully performed this technique in two cases of RARP.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3336976
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