医学
外科
输尿管
肾积水
宫颈癌
放射治疗
围手术期
机械人手术
放射科
泌尿系统
癌症
内科学
作者
Adam S. Baumgarten,Bhavik Shah,Trushar Patel,Lucas Wiegand
出处
期刊:Urology
[Elsevier]
日期:2017-06-01
卷期号:104: 9-10
被引量:8
标识
DOI:10.1016/j.urology.2017.02.033
摘要
ObjectiveTo present a novel surgical concept using preoperative imaging to estimate length needed for ileal segment. This enables robotic ileal interposition to be completed with only 1 position change during surgery.Materials and MethodsThe index patient is a 69-year-old woman with a history of stage IIIB cervical cancer treated with chemotherapy and radiation 5 years prior to presentation. The patient subsequently developed a long segment stricture of the left ureter, which had been managed with ureteral stents. The patient decided to proceed with robotic ileal ureter for management of her ureteral stricture disease. We used preoperative computed tomography scan measurements to estimate length needed for ileal segment. This eliminated the need for multiple position changes during surgery.ResultsThe patient tolerated the procedure well. Estimated blood loss was 50 cc. Kidney ultrasound at 1 month post-op revealed no hydronephrosis. Renal scan at 12 months post-op revealed stable function at 32% and no evidence of obstruction. The patient reports she is doing well and is pain free at this time.ConclusionRobotic ileal interposition is a technically feasible procedure with good functional outcomes. By using preoperative imaging to estimate length needed for ileal segment, only 1 position change is needed during surgery. To present a novel surgical concept using preoperative imaging to estimate length needed for ileal segment. This enables robotic ileal interposition to be completed with only 1 position change during surgery. The index patient is a 69-year-old woman with a history of stage IIIB cervical cancer treated with chemotherapy and radiation 5 years prior to presentation. The patient subsequently developed a long segment stricture of the left ureter, which had been managed with ureteral stents. The patient decided to proceed with robotic ileal ureter for management of her ureteral stricture disease. We used preoperative computed tomography scan measurements to estimate length needed for ileal segment. This eliminated the need for multiple position changes during surgery. The patient tolerated the procedure well. Estimated blood loss was 50 cc. Kidney ultrasound at 1 month post-op revealed no hydronephrosis. Renal scan at 12 months post-op revealed stable function at 32% and no evidence of obstruction. The patient reports she is doing well and is pain free at this time. Robotic ileal interposition is a technically feasible procedure with good functional outcomes. By using preoperative imaging to estimate length needed for ileal segment, only 1 position change is needed during surgery.
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