肾移植术后使用吲哚菁绿的机器人辅助原发性肾盂输尿管造口术。

IF 0.9 Q4 ORTHOPEDICS
Nour Khalil, Julien Sarkis, Alexandre Ingels
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引用次数: 0

摘要

导言:肾移植输尿管膀胱造口术后输尿管狭窄和膀胱输尿管反流可通过内窥镜手术(如球囊扩张和内窥镜注射)进行处理。然而,复杂/复发性病例通常需要通过重建手术来处理。我们在此重点介绍机器人辅助下的吲哚菁绿(ICG)原发性肾盂输尿管造口术:一名 57 岁的女性被诊断出移植肾上有 4 级膀胱输尿管反流,被认为是输尿管再植的候选人。在内窥镜部分将 ICG 插入肾盂后,我们开始进行机器人原位肾盂输尿管造口术。在萤火模式下,借助 ICG 识别移植肾的肾盂。解剖移植肾肾盂后,我们使用原生输尿管进行了无张力肾盂输尿管造口术。术后过程顺利,患者于术后第三天出院:讨论:机器人辅助肾盂输尿管造口术似乎是利用原生输尿管治疗肾移植术后复杂泌尿系统并发症的一种安全有效的技术。盆腔内 ICG 注射是开放手术无法实现的,它有助于识别移植肾盂,从而缩短手术时间,避免对移植肾血管蒂进行不必要的剥离。由于剥离最小且手术时间短,因此无需进行腹腔引流,术后过程通常很顺利,很快就能出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Robotic-assisted native pyeloureterostomy with indocyanine green, after kidney transplantation

Robotic-assisted native pyeloureterostomy with indocyanine green, after kidney transplantation

Introduction

Postoperative ureteral strictures and vesicoureteral reflux after ureteroneocystostomy for kidney transplant can be managed by endoscopic procedures like balloon dilation and endoscopic injections. Complicated/recurrent cases, however, are usually managed by reconstructive surgery. We hereby highlight our technique of robotic-assisted native pyeloureterostomy with indocyanine green (ICG).

Materials and Surgical Technique

A 57-year-old woman, diagnosed with grade 4 vesicoureteral reflux on her transplanted kidney, was considered a candidate for ureteral reimplantation.

After an endoscopic part, where the ICG is inserted into the renal pelvis, we proceed with the robotic native pyeloureterostomy. The renal pelvis of the transplanted kidney was identified with the help of the ICG in firefly mode. After the dissection of the graft pelvis, we performed a tension-free pyeloureterostomy using the native ureter. The postoperative course was uneventful and the patient was discharged on the third postoperative day.

Discussion

Robotic-assisted pyelo-ureterostomy appears as a safe and efficient technique for management of complicated urological complications postrenal transplantation using the native ureter. Intrapelvic ICG injection, not possible with open surgery, helps identifying the grafted pelvis thus reducing operative time and avoiding unnecessary dissection of the vascular hilum of the graft. Because of minimal dissection and the short operative time, abdominal drainage is unnecessary and the postoperative course is usually uneventful with a fast discharge from the hospital.

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CiteScore
2.00
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