Name:
Robot-Assisted Laparoscopic Removal of Upper Pole Moiety in Children with Complete Duplicated System
Description:
Robot-Assisted Laparoscopic Removal of Upper Pole Moiety in Children with Complete Duplicated System
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/d903c16f-dfc8-4752-8b62-9618cfa8348b/videoscrubberimages/Scrubber_1.jpg?sv=2019-02-02&sr=c&sig=w2Rj4eTCosPbvzvb5mhcPxo945D54XJg%2BkqrubmHXoE%3D&st=2026-03-09T17%3A06%3A34Z&se=2026-03-09T21%3A11%3A34Z&sp=r
Duration:
T00H04M12S
Embed URL:
https://stream.cadmore.media/player/d903c16f-dfc8-4752-8b62-9618cfa8348b
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/d903c16f-dfc8-4752-8b62-9618cfa8348b/187698597-UreteralClippingmp4.mp4?sv=2019-02-02&sr=c&sig=faDY8HourXVhgFlrwS1wASgybGJkLf0CjfuFhQPWSTk%3D&st=2026-03-09T17%3A06%3A34Z&se=2026-03-09T19%3A11%3A34Z&sp=r
Upload Date:
2024-04-06T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
SPEAKER: An eight-year-old girl presented to our clinic with continuous urinary incontinence. On physical examination, an ectopic urethral orifice in the introitus was revealed. Following the patient's radiologic and functional evaluation, which indicated a left duplicate system and the left renal upper pole with 5% function, a robot-assisted laparoscopic removal of the upper pole moiety was scheduled. After anesthesia induction, the patient was placed in the lithotomy position.
SPEAKER: And an open-ended urethral catheter was placed in the collecting system to be protected. Then the patient is taken to a lateral position with a mild lumbar hyperextension. The pneumoperitoneum is created with the Hasson technique. Three 8-millimeter robot ports and a 5-millimeter assistant trocar were placed as shown in the figure using the abdominal sling suture technique.
SPEAKER: The descending colon was mobilized, and then accessory spleen was visualized.
SPEAKER: Following the proper dissection, the ureter of the left upper pole was exposed. Then the ureter was separated from the surrounding tissue by sharp and blunt dissections using cautery.
SPEAKER: After the ureter was completely released, it was obliterated using clips and cauterized with bipolar. Although it seems that the pouch associated with the collecting system is created after this technique, according to our experience, no postoperative urinary tract infection or flank pain suggestive of hydronephrosis is observed in the postoperative period. Other reports in the literature have shown that a short-term increase in hydronephrosis was observed in the relevant renal segment, which was clinically insignificant and asymptomatic.
SPEAKER: After clipping off the ectopic ureter, the upper pole artery was also clipped. And all the collecting system structures related to the upper pole moiety was excised as possible. Due to clipping of both the vasculature and the ureter, the complete atrophy of the parenchyma and regression of hydronephrosis were observed without the development of any symptoms.
SPEAKER: The procedure was then continued with the complete vitrectomy of the relevant segment. The released ectopic ureter was excised from the distal end and taken out with a grasper. The left kidney was retroperitonealized. And the procedure was finalized by placing a silicone drain into the operation site. The docking time was 25 minutes. And the duration of surgery was 108 minutes.
SPEAKER: Both the urethral and the urethral catheters were removed postoperatively. And the patient was completely dry and continent immediately after surgery. The abdominal drain was removed on postoperative day two. The patient was discharged with full recovery on postoperative day three. No complications or symptoms may be related to our technique were reported in the follow-up of the patient.
