Single-Port, Robot-Assisted Transanal Harvest of Rectal Mucosa Grafts for Substitution Urethroplasty.
Urology
; 166: 1-5, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35513133
ABSTRACT
OBJECTIVE:
To describe a novel single-port, endorobotic technique for harvesting rectal mucosa grafts (RMGs) for urethral reconstruction.METHODS:
A 57-year-old man with prior transurethral procedures developed recurrent obstructive voiding symptoms. Urethrography revealed a panurethral stricture, meatus to the bulbomembranous junction. It was decided to proceed with surgical repair. Owing to the stricture's length, available oral mucosa would require additional material, and repair with a single rectal mucosa graft was offered instead. Single-port (SP) endorobotic approach offered ideal access for transanal harvest. With the patient placed in a modified lithotomy position, a GELPOINT Path transanal access platform was inserted through the anal canal. Pneumorectum was established at 12 mmHg with an AirSeal CO2 insufflator. A Da Vinci SP surgical system was docked, equipped with Maryland bipolar forceps and a monopolar spatula. After injection of ORISE gel, endorobotic submucosal dissection began posteriorly proximal to the dentate line.RESULTS:
Proceeding cranially through the rectal submucosa, a 21 â 3 cm strip of mucosa was obtained with appropriate hemostasis. The resulting graft was thoroughly thinned. The robot was undocked, and the patient repositioned to high lithotomy. The patient underwent a penis-inverting, dorsolateral approach augmentation urethroplasty. With an indwelling catheter placed, the patient was discharged on postoperative day 2 with no postoperative complications.CONCLUSION:
Transanal rectal mucosal dissection with a single-port endorobotic approach can be an enticing and minimally invasive harvesting technique to provide substitution grafts for long-segment urethral reconstruction.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estreitamento Uretral
/
Robótica
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article