Tubo-ovarian deflection facilitates access to the ureterovesical junction in robotic ureteral reimplantation for vesicoureteral reflux in children: A novel surgical modification.

IF 1.9 3区医学 Q2 PEDIATRICS

Journal of Pediatric Urology Pub Date : 2025-10-03 DOI:10.1016/j.jpurol.2025.09.033

Yanay Shaked, Omri Schwarztuch Gildor, Anna Itshak, Amos Neheman

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引用次数: 0

Abstract

Introduction: Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is a well-established surgical approach in girls with high-grade vesicoureteral reflux (VUR). Adequate exposure of the distal ureter and ureterovesical junction is crucial to achieve good outcomes.

Methods: We present a novel modification, the medial tubo-ovarian deflection (MTOD), which improves exposure of the distal ureter by dissecting the round ligament and separating the proximal peritoneum along the white line, close to the bladder.

Results: Nine girls (median age 25 months) underwent MTOD during RALUR-EV. Median console time was 105 min, and no intraoperative complications were reported. All patients were discharged the day after surgery. The short-term complications included two postoperative febrile UTIs, none of them had reflux on VCUG and one case of transient urinary retention. No ovary-related complications were reported. Median follow-up was 20 months.

Conclusion: Performing MTOD during RALUR-EV is safe and reproducible, with good outcomes in short-term follow-ups.

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输卵管卵巢偏转在儿童膀胱输尿管反流的机器人输尿管再植术中便于进入输尿管-膀胱交界处：一种新的手术改良。

机器人辅助腹腔镜输尿管外再植（RALUR-EV）是一种成熟的手术方法，用于治疗高度膀胱输尿管反流（VUR）的女孩。充分暴露输尿管远端和输尿管膀胱交界处是获得良好结果的关键。方法：我们提出了一种新的修改，内侧输卵管卵巢偏转（MTOD），它通过解剖圆形韧带和沿着靠近膀胱的白线分离近端腹膜来改善远端输尿管的暴露。结果：9名女孩（中位年龄25个月）在RALUR-EV期间接受了MTOD。中位坐位时间为105 min，无术中并发症报道。所有患者均于术后第1天出院。短期并发症包括2例术后发热性尿路感染，无一例VCUG反流，1例短暂性尿潴留。无卵巢相关并发症报道。中位随访时间为20个月。结论：在RALUR-EV中进行MTOD是安全的，可重复性好，短期随访效果良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY

CiteScore

3.70

自引率

15.00%

发文量

330

审稿时长

4-8 weeks

期刊介绍： The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.