V05-03: Robotic repair of left uretero-neobladder anastomotic stricture following prior robotic radical cystectomy and intracorporeal neobladder diversion
Uretero-ileal anastomotic stricture is a well-known complication following radical cystectomy and urinary diversion with a rate of 8-12% in open and robotic series. Some strictures can be managed endoscopically but many require revision of the uretero-ileal anastomosis. With increased utilization of robotic radical cystectomy we have started revising these strictures with a robotic approach as well.
From September 2014 - October 2016 we have performed 75 robotic radical cystectomies with 15 undergoing robotic intracorporeal ileal conduit urinary diversion. We found 1 patient that developed a uretero-neobladder stricture. In the following video we highlight the technique for robotic revision of a left-sided uretero-neobladder anastomotic stricuture in a patient following prior robotic radical cystectomy and intracorporeal neobladder urinary diversion.
Our uretero-ileal anastomotic stricture rate following robotic radical cystectomy with intracorporeal neobladder urinary diversion is 7% although our numbers are not large enough for valid reporting as of yet. We successfully performed a robotic uretero-ileal anastomotic revision. Operative time was 65 minutes, EBL was 100cc, and length of stay was 1 day.
Uretero-neobladder anastomotic strictures following robotic radical cystectomy and intracorporeal neobladder urinary diversion can safely and effectively be managed with a robotic approach