Urology video journal最新文献

{"title":"Sutureless clampless robot-assisted partial nephrectomy for a CT2 complex cystic renal masses","authors":"Vincenzo Asero , Roberta Catuzzi , Rocco Simone Flammia , Eugenio Bologna , Leslie Claire Licari , Arianna Bernardotto , Costantino Leonardo","doi":"10.1016/j.urolvj.2024.100263","DOIUrl":"https://doi.org/10.1016/j.urolvj.2024.100263","url":null,"abstract":"","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089724000033/pdfft?md5=9ff53fa0815ba813e2931b6e45643745&pid=1-s2.0-S2590089724000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The LAPE pouch: A solution to specimen storage in total extra-peritoneal RLRP","authors":"Ee Jean Lim ,&nbsp;Alvin YM Lee ,&nbsp;Yu Guang Tan ,&nbsp;Yan Mee Law ,&nbsp;Tze Kiat Ng ,&nbsp;Kenneth Chen ,&nbsp;John SP Yuen","doi":"10.1016/j.urolvj.2024.100267","DOIUrl":"https://doi.org/10.1016/j.urolvj.2024.100267","url":null,"abstract":"<div><h3>Introduction</h3><p>We describe a novel creation of a triangular extra-peritoneal space bounded by the <strong><u>l</u></strong>ateral <strong><u>a</u></strong>bdominal wall laterally, <strong><u>p</u></strong>eritoneal reflection medially and inferior <strong><u>e</u></strong>pigastric vessels distally (the LAPE pouch) that serves as an ideal entrapment pouch for specimen storage in TEP-RLRP.</p></div><div><h3>Patients and methodology</h3><p>50 consecutive patients underwent TEP-RLRP with the creation of the LAPE pouch for specimen storage. Inclusion criteria for TEP-RLRP were: (1) BMI ≤35 kg/m², and (2) MRI prostate volume of ≤80 ml. Patient's demographics, intraoperative data (LAPE creation time, blood loss) and post-operative complications were analyzed. The step-by-step technique of LAPE pouch creation is as follows: (1) creation of extra-peritoneal space; (2) identification of key anatomical boundaries; (3) blunt dissection to create the LAPE pouch; (4) the fourth robotic port insertion at the tip of the LAPE triangular.</p></div><div><h3>Results</h3><p>The mean age of patients was 66 years (51–77), mean BMI of 24.6 kg/m² (19.8–34.8), mean PSA of 7.9 ng/ml (1.4–18), and mean MRI-measured prostate volume of 45.1 ml (20–80). Mean dissection time for LAPE pouch was 1.4 min (1.0–3.1). All specimens were successfully placed in the pouch with only one (2%) specimen displacement after placement intraoperatively. There were no complications because of LAPE pouch creation or use. Mean final prostate size corresponds well with MRI-measured prostate volume (47.9 gram vs 45.1 ml).</p></div><div><h3>Conclusions</h3><p>This study presents a novel, safe and easy technique in creating an additional triangular extra-peritoneal space that overcome the pitfall of TEP RLRP in specimen storage.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100267"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089724000070/pdfft?md5=f152a6c538c7ac22d3e6a98c6e8d0e3f&pid=1-s2.0-S2590089724000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic urachal cyst removal: Video case report and tutorial for robotic surgical trainees","authors":"Jordan M. Rich,&nbsp;Ashley N Gonzalez,&nbsp;Katie S. Murray","doi":"10.1016/j.urolvj.2024.100265","DOIUrl":"https://doi.org/10.1016/j.urolvj.2024.100265","url":null,"abstract":"<div><h3>Background</h3><p>The urachus is a fibrous cord that arises from the anterior bladder wall and extends to the umbilicus, degenerating after birth <span>[1]</span>. Urachal cysts are congenital abnormalities resulting from incomplete obliteration of the urachus into the median umbilical ligament <span>[2]</span>, <span>[3]</span>, <span>[4]</span>. The cyst often remains asymptomatic but can present with symptoms associated with urinary tract infection, abdominal pain, erythema, swelling, and hematuria <span>[5]</span>. When left untreated, can lead to severe complications like rupture and sepsis <span>[6]</span>. Definitive treatment is with excision, which can be performed via an open, laparoscopic, and robotic approach.</p></div><div><h3>Objective</h3><p>To present a video case report of robotic-assisted excision of a urachal cyst, highlighting key takeaways for robotic surgical trainees.</p></div><div><h3>Methods and Materials</h3><p>We report a 24-year-old previously healthy male who presents with umbilical pain for one week and drainage from the umbilicus for one day. He had a similar episode ten years ago which self-resolved within a day. CT abdomen/pelvis with contrast notable for a 1.8 cm rim-enhancing fluid collection deep to the umbilicus. Patient was treated with a course of Bactrim with resolution of his symptoms and interval imaging notable for resolution of fluid collection. Patient decided to proceed with robotic-assisted excision of urachal cyst due to recurrent infections and drainage.</p></div><div><h3>Results</h3><p>Intra-operatively, the urachal cyst was identified and skeletonized to the level of the umbilicus and then down to the level of the bladder. The cyst was excised with a circumferential margin, and the resulting bladder defect that was closed in two layers. After the bladder was filled demonstrating no leak, the urachal cyst was removed without complication.</p></div><div><h3>Conclusions</h3><p>Urachal cysts are a congenital anomaly that can present with a wide variety of clinical presentations [<span>7</span>,<span>8</span>]. Robot-assisted removal provides a minimally invasive technique for successful excision of a urachal cyst when indicated.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100265"},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089724000057/pdfft?md5=c7da0f0ebb20dffd181d757c5a7126de&pid=1-s2.0-S2590089724000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperitoneal and retroperitoneal robot-assisted partial nephrectomy with the Hugo™ RAS system: Video instructions and initial experience from a tertiary care referral centre","authors":"Francesco Chierigo ,&nbsp;Alberto Caviglia ,&nbsp;Valerio Cellini ,&nbsp;Ofir Maltzman ,&nbsp;Alberto Olivero ,&nbsp;Michele Barbieri ,&nbsp;Silvia Secco ,&nbsp;Stefano Tappero ,&nbsp;Aldo Massimo Bocciardi ,&nbsp;Antonio Galfano ,&nbsp;Paolo Dell'Oglio","doi":"10.1016/j.urolvj.2023.100255","DOIUrl":"10.1016/j.urolvj.2023.100255","url":null,"abstract":"<div><h3>Introduction</h3><p>To describe operatory room (OR) setting, trocar placement, surgical technique and perioperative outcomes of retroperitoneal (rRAPN) and transperitoneal (tRAPN) robot-assisted partial nephrectomy with the Hugo™ robot-assisted surgical (RAS) system.</p></div><div><h3>Patients and surgical procedure</h3><p>We present our prospective, series of the first ten consecutive patients submitted to either rRAPN or tRAPN with the Hugo™ RAS system (Medtronic, Minneapolis, MN, USA) at ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy, between April 2023 and June 2023. The outcomes of interest were to describe the OR setting, trocar placement and the performance of this novel robotic system. Pre, intra and post-operative variables were recorded. A descriptive analysis was performed.</p></div><div><h3>Results</h3><p>Overall, ten patients underwent RAPN with the Hugo™ RAS system, of which two were rRAPN (one left and one right renal mass) and eight tRAPN (two left, five right, one bilateral). Median (interquartile range, IQR) tumor size was 2.75 cm, with a median PADUA score of 7 (7,9). Median time from first trocar placement to console was 20 (15, 23) minutes, median console time was 136 (100, 159) minutes, and median operative time was 185 (170, 232) minutes. No intra-operative complications were recorded. Four post-operative complications were reported: one patient developed acute kidney injury (AKI, Clavien-Dindo 1), one patient required a longer hospital stay due to chylous production from the drain after hilar lymphadenectomy (Clavien-Dindo 2) and two pneumothoraxes (Clavien-Dindo 3a). Median (IQR) hospital stay was 5 (3,7) days. At final pathology, clear cell RCC, papillary RCC, chromophobe RCC and oncocytoma were found in respectively seven (70 %), one (10 %), one (10 %), and one (10 %) patients, with T1a, T1b and T3a (perirenal fat invasion) stages in six (60 %), three (30 %) and one (10 %) patients, respectively.</p></div><div><h3>Conclusions</h3><p>This video article illustrates the steps of both rRAPN and tRAPN with the Hugo™ RAS system. Our preliminary results demonstrate that both rRAPN and tRAPN are feasible with this novel robotic platform. Future large case series with long-term follow-up are needed to understand whether Hugo™ RAS system represents a true alternative to Intuitive platforms for nephron-sparing surgery.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259008972300049X/pdfft?md5=f6c7cb8d5577cd910c8250ef666cc8d0&pid=1-s2.0-S259008972300049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the retropubic approach to robotic simple prostatectomy","authors":"Dhruv Puri,&nbsp;Eric Y Cho,&nbsp;Kian Ahmadieh,&nbsp;Jill C Buckley","doi":"10.1016/j.urolvj.2023.100259","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100259","url":null,"abstract":"<div><h3>Background</h3><p>There are several surgical options for the treatment of Benign Prostatic Hyperplasia (BPH). The retropubic approach to a robotic simple prostatectomy has been previously described as an acceptable option for patients with large prostates (greater than 80–100 g). We present 15 cases who were candidates for robotic simple prostatectomy <em>via</em> a retropubic approach.</p></div><div><h3>Objective</h3><p>To describe the retropubic approach to robotic simple prostatectomy alongside relevant quantifiers of patient outcomes and quality of life measures.</p></div><div><h3>Patient and surgical procedure</h3><p>We report the case series of 15 patients diagnosed with BPH and underwent robotic simple prostatectomy <em>via</em> a retropubic approach between June 2020 and June 2023.</p></div><div><h3>Results</h3><p>The mean total operative time was 182.4 min (median 176 min), the mean estimated blood loss was 122 ml, the median catheter time was 9 days (commonly 7 days for patients) and the average length of stay was 35 h. The average prostate size was 107.2 g and the average resected specimen weight was 66.1 g. IPSS improved on average 8.9 points with an improvement in QOL by 2.3 points. The mean post operative post void residual volume (PVR) was 74.2 ml, and the PVR had a significant change of 279.3 ml on average when comparing pre and postoperatively. There was an improvement in urinary flow rate when comparing the preoperative and postoperative (9.4 and 13.4 ml/s, respectively). Surgical indications included 14 patients with urinary retention, three patients with a history of recurrent UTIs, and two patients with bladder stones. No transfusions were required. Postoperatively, one patient had recurrent UTIs and one had a neurogenic bladder. When assessing for postoperative strictures or de novo urinary incontinence, none were identified.</p></div><div><h3>Conclusion</h3><p>Utilizing a retropubic technique for a robotic assisted simple prostatectomy demonstrated excellent functional outcomes and limited risk. The superior visualization of the apex of the prostate and simple capsular closure resulted in no postoperative strictures or de novo urinary incontinence.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000531/pdfft?md5=eb6e6c5aa2ca2b22004e35c39b8432a9&pid=1-s2.0-S2590089723000531-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138548775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICG marked robot-assisted partial nephrectomy for totally endophytic renal masses","authors":"Vincenzo Asero ,&nbsp;Roberta Catuzzi ,&nbsp;Ivan Di Giulio ,&nbsp;Luca Antonelli ,&nbsp;Veronica Palombi ,&nbsp;Eugenio Bologna ,&nbsp;Flavia Proietti ,&nbsp;Costantino Leonardo","doi":"10.1016/j.urolvj.2023.100249","DOIUrl":"10.1016/j.urolvj.2023.100249","url":null,"abstract":"","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"21 ","pages":"Article 100249"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000439/pdfft?md5=6ee534002a248da367b1b55940fbc363&pid=1-s2.0-S2590089723000439-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136153887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic bladder neck reconstruction using a double-faced buccal mucosal graft - A novel approach to complete bladder neck obliteration","authors":"Devang Desai,&nbsp;Kale Munien,&nbsp;Benjamin Namdarian","doi":"10.1016/j.urolvj.2023.100247","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100247","url":null,"abstract":"<div><h3>Objective</h3><p>Bladder neck contractures (BNCs) are a well-documented, but acceptably uncommon late adverse outcome of surgical treatment for benign prostatic hyperplasia. Urologists successfully manage short segment contractures with endoscopic approaches, but recurrence rates are significant. When two endoscopic attempts fail, or in the case of long segment contractures and complete obliteration of the bladder neck, reconstruction and grafting are the mainstay. In this submission we aim to describe a new surgical solution to the completely obliterated bladder neck and prostatic fossa - a robot assisted laparoscopic (RAL) bladder neck reconstruction using an anterior and posterior buccal mucosal graft to create a double-faced repair.</p></div><div><h3>Methods and Surgical Procedure</h3><p>A 70-year-old male with a history of BPH presented with recurrent bladder neck contractures after an initial TURP. Being recalcitrant to four attempts at endoscopic correction, he was dependant on a suprapubic catheter (SPC) for 18 months. Retrograde urethrogram and SPC-gram confirmed a complete obliteration of the bladder neck and prostatic fossa. The patient underwent a RAL bladder neck reconstruction with a double face buccal mucosal graft. There were no perioperative complications.</p></div><div><h3>Results</h3><p>The patient was discharged on day 2 without perioperative complications. His IDC was removed and SPC clamped at 3 weeks, and the patient was voiding spontaneously without incontinence. At his 7-month follow-up the patient remained continent with a Qmax of 23 ml/s where he previously had no flow at all. His residual bladder volume was 125 ml. He has had no change in his erectile function. His postoperative IPSS was 3, and his quality of life “delighted”.</p></div><div><h3>Conclusions</h3><p>We present a new surgical alternative to treat an obliterated bladder neck whereby we completely reconstruct the defect with a double-faced buccal mucosal graft. Significant morbidity is avoided by the robot assisted transvesical approach, especially in regard to continence and erectile function. As technology becomes more readily available, this procedure will be easily replicated by adequately trained Urologists.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49724752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial for robotic kidney and adrenal surgery","authors":"Ronney Abaza","doi":"10.1016/j.urolvj.2023.100243","DOIUrl":"10.1016/j.urolvj.2023.100243","url":null,"abstract":"","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000373/pdfft?md5=7b80928cbdeec08b88057482a740875e&pid=1-s2.0-S2590089723000373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42915686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-clamp robotic partial nephrectomy: Points of technique","authors":"Riccardo Bertolo ,&nbsp;Matteo Vittori ,&nbsp;Marco Carilli ,&nbsp;Michele Di Dio ,&nbsp;Pierluigi Bove","doi":"10.1016/j.urolvj.2023.100257","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100257","url":null,"abstract":"<div><h3>Objective</h3><p>To present a stepwise approach to off-clamp robotic partial nephrectomy (RPN), focusing on tips and tricks.</p></div><div><h3>Patients and surgical procedure</h3><p>Two emblematic cases are presented to describe the technique. The first one refers to a 27 years-old guy diagnosed with a 5-cm – R.E.N.A.L. 7 – right-sided mass located at the lower pole. The second case presented refers to a 69 years-old gentleman diagnosed with a 5-cm – R.E.N.A.L. 9 – suspicious mediorenal right-sided mass. After accurate counseling, the patients underwent off-clamp RPN.</p></div><div><h3>Results</h3><p>In the first case, a mini-enucleo-resection technique was pursued (Surface-Intermediate-Base score = 1–2). Selective single-layer renorrhaphy was performed at the end due to bleeding foci. Final pathology revealed low-grade oncocytic tumor, pT1b, R0. In the second case, a pure enucleation resection technique was pursued (Surface-Intermediate-Base score = 0). No renorrhaphy was performed at the end of the anatomical resection given the absence of active bleeding. Pathology analysis revealed a clear cell renal cell carcinoma, pT1b, G3, with negative margins.</p></div><div><h3>Conclusions</h3><p>Off-clamp approach can represent a viable alternative during RPN. Tumor enucleation resection technique has the perfect synergistic effect in maximizing the perioperative vision notwithstanding the avoided renal artery clamping. Moreover, it sponsors a minimized “nephron sparing” renorrhaphy.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100257"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000518/pdfft?md5=ee3fac434818acb382c99dd8cc9dfc3a&pid=1-s2.0-S2590089723000518-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90004127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath","authors":"Alexander Combes,&nbsp;Henry Wang,&nbsp;Sean Heywood,&nbsp;Sachinka Ranasinghe,&nbsp;Jeremy Saad,&nbsp;Raymond Ko,&nbsp;Nicholas Mehan","doi":"10.1016/j.urolvj.2023.100254","DOIUrl":"https://doi.org/10.1016/j.urolvj.2023.100254","url":null,"abstract":"<div><h3>Objective</h3><p>The treatment of large intra renal stones with concomitant ureteropelvic junction obstruction (UPJO) can be managed with concurrent procedures. Endoscopic assisted robotic pyelolithotomy and pyeloplasty has been demonstrated to be safe and effective yet the use of a ureteric access sheath in such cases is not well documented. This article emphasises the use and advantages of a ureteric access sheath (UAS) to improve the control, decrease infection rates and minimise intrarenal pressures during endoscopic management in robotic pyelolithotomy and pyeloplasty.</p></div><div><h3>Patients and Surgical Procedure</h3><p>A 46-year-old female with a left ureteropelvic junction obstruction (UPJO) underwent an endoscopic assisted robotic pyelolithotomy and pyeloplasty for management of her UPJO and removal of stones. The renal pelvis was identified, incised, and a ureteric access sheath (UAS) was inserted through a robotic port into the renal pelvis and controlled using a robotic arm. Flexible pyeloscopy and subsequent basket removal of the stones was performed minimising any potential spillage of irrigation fluid into the abdominal cavity. The pyelotomy was closed using an Anderson-Hynes dismembered pyeloplasty.</p></div><div><h3>Results</h3><p>The operative time was 150 min and blood loss &lt;50 ml. The patient was discharged on post-operative day 2 without any complications and a stable serum creatinine.</p></div><div><h3>Conclusion</h3><p>Endoscopic assisted robotic pyelolithotomy and pyeloplasty with a UAS is a safe and effective procedure for managing a concurrent UPJO and intra renal stones. This technique gives the surgeon maximal control of UAS positioning and location and may also decrease intrarenal pressures and reduce the risk of infection.</p></div>","PeriodicalId":92972,"journal":{"name":"Urology video journal","volume":"20 ","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590089723000488/pdfft?md5=b039b46182f9e766f098ad2c59fee83b&pid=1-s2.0-S2590089723000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92026665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}