AB178. SOH26AB_0131. Ureteral reconstruction techniques in the era of robotic-assisted surgery: a systematic review
Urology Posters

AB178. SOH26AB_0131. Ureteral reconstruction techniques in the era of robotic-assisted surgery: a systematic review

Aoife Sheahan1, Cian Hehir1, Gavin Calpin1, Barry McGuire2

1Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 2Department of Urology, St. Vincent’s University Hospital, Dublin, Ireland

Background: Robotic-assisted surgery has transformed upper urinary tract reconstruction, overcoming limitations of laparoscopic and open surgery. We aimed to evaluate the safety and efficacy of various robotic-assisted ureteral reconstruction techniques.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reconstruction techniques were sub-grouped into proximal, mid, and distal ureter. Underlying pathology, reconstruction technique, and intra- and post-operative outcomes were evaluated.

Results: There were 34 studies included with 1,173 patients. Distal ureteral reconstruction included ureteral reimplantation (30.7%, 103/335), Boari flap (BF) (22.1%, 74/335), psoas hitch (34.9%, 117/335), ureteroureterostomy (UU) (11.0%, 37/335), and graft reconstruction (1.2%, 4/335). Median operative time (OT) was 2.81–3.53 h, and median blood loss was 58.75–105 mL. Success rates of 91.8–100% were reported with no significant post-operative complications. One case (0.29%) was converted to open surgery. Proximal ureteral reconstruction included pyeloplasty (85.4%, 691/809), UU (1.6%, 13/809), ureterocalicostomy (0.6%, 5/809), and graft reconstruction (12.4%, 100/809). Median OT was 2.66 h, and median blood loss was 66.3 mL. Success rates of 95.9–100% were reported with 1 (0.12%) conversion to open surgery. Clavien-Dindo grades 3–5 complications occurred in 2 patients (0.24%). Mid-ureteral reconstruction included BF (62.1%; 18/29), UU (24.1%; 7/29), and ureteroplasty with appendiceal flap or interposition graft (UAF; 13.7%; 4/29). Median OT was 3.85 h (BF), 2.53 h (UU), and 4.78 h (UPF). Median blood loss was 50 mL (BF and UU) and 75 mL (UPF), and a 100% success rate was reported.

Conclusions: Robotic-assisted ureteral reconstruction offers high success rates and favourable perioperative outcomes, reinforcing its suitability for complex upper tract reconstruction.

Keywords: Ureteric reconstruction; urology; robotic-assisted surgery; pelvi-ureteric junction obstruction; ureteric stricture

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab178
Cite this abstract as: Sheahan A, Hehir C, Calpin G, McGuire B. AB178. SOH26AB_0131. Ureteral reconstruction techniques in the era of robotic-assisted surgery: a systematic review. Mesentery Peritoneum 2026;10:AB178.

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