Robotic non-transecting ureteroneocystostomy (reimplantation) is an efficacious alternative to conventional reimplantation for mid- to distal ureteral strictures. We sought to update our multi-institutional experience with this technique and analyze intermediate-term outcomes.

METHODS:

We retrospectively reviewed a multi-institutional database of robotic ureteral reconstruction (CORRUS, or Collaborative of Reconstructive Robotic Ureteral Surgery) for patients undergoing robotic non-transecting reimplantation. Demographic, perioperative, and postoperative data were captured and reported using descriptive statistics. The primary outcome of interest was freedom from recurrent ureteral stenosis, defined as the absence of obstructive findings on follow-up imaging. Minimum follow-up duration for inclusion was three months.

RESULTS:

We identified 50 patients (comprising 55 ureters) who underwent robotic non-transecting ureteroneocystostomy between 2016 and 2022. Demographic, perioperative, and postoperative data are shown in the accompanying Table 1. Median stricture length was 2.8 cm (IQR 1–4). 17 patients (34%) had a history of radiation and 28 (56%) had prior abdominal or pelvic surgeries. 15 patients (30%) failed endoscopic stricture management; three (6%) failed prior reconstructive attempts. There was one intraoperative complication, a gastric injury repaired primarily by general surgery without subsequent sequelae. There were no immediate (≤30 days) postoperative complications. Over a median follow-up of 17.1 months (7.2–32.0), 47 patients (94%) comprising 52 ureters (95%) remained free from recurrent stricture disease.

CONCLUSIONS:

Our updated experience reaffirms the safety and efficacy of robotic non-transecting ureteral reimplantation. Despite a high proportion of patients with complex stricture disease, reimplantation was accomplished with minimal morbidity, satisfactory patency rates, and durable outcomes.