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Reconstructive surgery

  • In the case of distal ureteral strictures, for example after previous operations in the urinary tract, a robot-assisted ureteral reimplantation can be performed using the psoas hitch technique or with the Boari flap plasty. In this procedure, the narrowed part of the ureter is removed. In the psoas hitch technique, the bladder is first raised by dissection. After fixation to the psoas muscle, the remaining ureter is re-implanted in the bladder wall. In Boari plasty, a flap is formed from the bladder wall to bridge larger ureteral defects. This is then formed into a tube and sutured to the stump of the healthy ureter. In both techniques, the created connection (anastomosis) is secured with a ureteral stent.
  • The advantage of the minimally invasive procedure with the da Vinci is the high surgical precision for both the surgeon and the patient. The use of the minimally invasive technique (360° angled instruments, 3-D view) simplifies the precise recording of the anatomical conditions and the preparation of the fine tissue of the ureter and its subsequent implantation in the bladder.
  • The patient is guaranteed a gentle operation with a good functional and cosmetic result. Patients can be discharged from hospital after 5-7 days.

Overview - DaVinci assisted ureteral reimplantation

Indication Ureteral stricture in the distal part of the ureter (just before the bladder)
Procedure Removal of the ureteral stricture and new suture connection with the urinary bladder through a minimally invasive approach. Enlarged view and 3-D view of the surgical area.
Operating time approx. 2 hours
Stay 5-7 days
Info Faster recovery than with incisional surgery. General anesthesia.
   
  • This procedure is usually used for shorter narrowings of the ureter. First, the affected part of the ureter is removed. A tension-free connection (anastomosis) is then created, in which both healthy ureter ends are sutured together without tension. The created anastomosis is secured with a ureteral stent.
  • The use of the minimally invasive da Vinci technique (360° angled instruments, 3-D view) simplifies the precise recording of the anatomical conditions and the preparation of the fine tissue of the ureter and its subsequent anastomosis.
  • A bladder diverticulum is a protrusion of the bladder wall. This can result in incomplete emptying of the bladder, which in turn can lead to bladder infections or the development of bladder stones. Surgery is then necessary. This can be performed with robotic assistance, which allows the protrusion to be removed particularly precisely and gently.