SHORT COMMUNICATION   

Minerva Urology and Nephrology 2021 October;73(5):672-3

DOI: 10.23736/S2724-6051.19.03628-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

How to manage a partial detachment of the ureter during robotic radical prostatectomy?

Fabrizio DAL MORO ^{1, 2} ✉, Federico GOFFO ², Giordana FERRAIOLI ², Carlotta ZABORRA ², Claudio VALOTTO ¹

¹ Department of Medicine, Udine University Hospital, Udine, Italy; ² Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy

The management of a ureteral orifice injury occurring during robotic radical prostatectomy (RARP) represents a challenge for urologists. Several techniques have been proposed to treat an intraoperative injury, but intraoperative positioning of a DJ stent represents the most common treatment in cases of a partial injury of the ureteral orifice. We present a technique to ensure the successful outcome in cases of a partial detachment of the ureter during RARP. When the orifice is identified after the incision of the bladder neck and it appears very close to the anastomosis line setting up a partial detachment of the ureter, before implanting a DJ stent, one tip could be to perform a small incision of the anterior wall of the orifice to spatulate it and then proceeding to a short slip of the ureter: the eversion of the mucosa - thus creating a sort of “folded shirt cuff” - allows the fixation of the ureter to the bladder wall. We successfully performed this technique in two cases of RARP.

KEY WORDS: Prostatectomy; Robotic surgical procedures; Ureter