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Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

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Abstract

The treatment of ureteral strictures represents a challenge due to the variability of aetiology, site and extension of the stricture; it ranges from an end-to-end anastomosis or reimplantation into the bladder with a Boari flap or Psoas Hitch. Traditionally, these procedures have been done using an open access, but minimally invasive approaches have gained acceptance. The aim of this study is to evaluate the safety and feasibility and perioperative results of minimally invasive surgery for the treatment of ureteral stenosis with a long-term follow-up. Data of 62 laparoscopic (n = 36) and robotic (n = 26) treatments for ureteral stenosis in 9 Italian centers were reviewed. Patients were followed according to the referring center’s protocol. Laparoscopic and robotic approaches were compared. All the procedures were completed successfully without open conversion. Average estimated blood loss in the two groups was 91.2 ± 71.9 cc for the laparoscopic and 47.2 ± 32.3 cc for the robotic, respectively (p = 0.004). Mean days of hospitalization were 5.9 ± 2.4 for the laparoscopic group and 7.6 ± 3.4 for the robotic group (p = 0.006). No differences were found in terms of operative time and post-operative complications. After a median follow-up of 27 months, the robotic group yielded 2 stenosis recurrence, instead the laparoscopic group shows no cases of recurrence (p = 0.091). Minimally invasive approach for ureteral stenosis is safe and feasible. Both robotic and pure laparoscopic approaches may offer good results in terms of perioperative outcomes, low incidence of complications and recurrence.

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Authors and Affiliations

  1. Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Palagi 9 Street, 40134, Bologna, Italy

    Riccardo Schiavina, Francesco Chessa, Cristian Vincenzo Pultrone & Marco Borghesi

  2. Department Of Urology, University of Eastern Piedmont Azienda Ospedaliero-Universitaria Maggiore Della Carità, Novara, Italy

    Stefano Zaramella & Carlo Terrone

  3. Department of Urology, Careggi Hospital, University of Florence, Florence, Italy

    Andrea Minervini, Andrea Cocci & Andrea Chindemi

  4. Department of Urology, University of Brescia, Brescia, Italy

    Alessandro Antonelli & Claudio Simeone

  5. Department of Urology, University of Bari “Aldo Moro”, Bari, Italy

    Vincenzo Pagliarulo

  6. Department of Urology, Ospedale “Carlo Poma” Mantova, Mantova, Italy

    Paolo Parma & Alessanrdo Samuelli

  7. Dept. Of Urology, Ospedale “San Bassiano”, Bassano del Grappa, VI, Italy

    Antonio Celia & Bernardino De Concilio

  8. Department of Urology, Policlinico Di Milano, Milan, Italy

    Bernardo Rocco & Elisa De Lorenzis

  9. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy

    Gaetano La Manna

  10. Department of Urology, Policlinico Vittorio Emanuele, Catania, Italy

    Mario Falsaperla

  11. Department of Urology, Policlinico Di Abano, Abano Terme, PD, Italy

    Donato Dente & Angelo Porreca

Authors
  1. Riccardo Schiavina
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  2. Stefano Zaramella
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  3. Francesco Chessa
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  4. Cristian Vincenzo Pultrone
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  5. Marco Borghesi
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  6. Andrea Minervini
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  7. Andrea Cocci
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  8. Andrea Chindemi
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  9. Alessandro Antonelli
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  10. Claudio Simeone
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  11. Vincenzo Pagliarulo
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  12. Paolo Parma
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  13. Alessanrdo Samuelli
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  14. Antonio Celia
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  15. Bernardino De Concilio
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  16. Bernardo Rocco
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  17. Elisa De Lorenzis
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  18. Gaetano La Manna
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  19. Carlo Terrone
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  20. Mario Falsaperla
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  21. Donato Dente
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  22. Angelo Porreca
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Corresponding author

Correspondence to Francesco Chessa.

Ethics declarations

All patients provided informed consent for anonymous publication of data.

Conflict of interest

Riccardo Schiavina, Stafano Zaramella, Francesco Chessa, Cristian Vincenzo Pultrone, Marco Borghesi, Andrea Minervini, Andrea Cocci, Andrea Chindemi, Alessandro Antonelli, Claudio Simeone, Vincenzo Pagliarulo, Paolo Parma, Alessandro Samuelli, Antonio Celia, Bernardino De Concilio, Bernardo Rocco, Elisa De Lorenzis, Carlo Terrone, Gaetano La Manna, Mario Falsaperla, Donato Dente and Angelo Porreca declare that they have not conflict of interest.

Ethical approval

The study was done in accordance with the Helsinki declaration and national regulations.

Informed consent

All patients provided informed consent for anonymous publication of data.

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Schiavina, R., Zaramella, S., Chessa, F. et al. Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up. J Robotic Surg 10, 323–330 (2016). https://doi.org/10.1007/s11701-016-0601-0

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  • DOI: https://doi.org/10.1007/s11701-016-0601-0

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