How to transform the intestine into the ureter? Da Vinci Surgical Robot Assists "Graft" Bracelet | Ureter | Robot
The ureter is an important channel connecting the kidneys and bladder. If the ureter is narrowed or even blocked due to congenital diseases or acquired injuries, urine cannot be discharged normally. In order to protect renal function and alleviate the problem of hydronephrosis, this group of people often need to replace ureteral stents multiple times a year or undergo long-term renal fistula drainage, treating the symptoms rather than the root cause. Repeatedly replacing the bracket regularly not only affects the quality of life, but also increases the risk of infection.
Recently, the urology repair team of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine took the lead in using a da Vinci surgical robot to perform a "total laparoscopic replacement of the ureter for the treatment of complex lateral ureteral stenosis" surgery in Shanghai. The surgery uses the patient's own intestine to replace the ureter, completing the ureter intestine bladder anastomosis and completely solving the problem of ureteral stenosis in patients.
"Transfer flowers and trees", the intestine transforms into the ureter
Patient Mr. Wang is 52 years old this year. Due to ureteral stone entrapment, there have been repeated ureteral stones and ureteral balloon dilation. Despite the removal of the ureteral stent, there is still hydronephrosis, secondary back pain, infection, etc., which seriously affects renal function and physical health. The Renji urology repair team first performed a combined retrograde ureterography on the patient, and found that there were upper, middle, and lower segment strictures in the ureter, with a length exceeding 15 centimeters.
Team leader Liu Yidong introduced, "The ureter of an average adult ranges from 25 to 35 centimeters. Based on comprehensive imaging and ureteroscopy, it was found that Mr. Wang already has almost complete ureteral stenosis. In addition, after multiple ureteral balloon dilation treatments, Mr. Wang's available normal ureter has weak elasticity and toughness, which poses great difficulties and challenges for subsequent surgeries."
After comprehensive consideration, the team developed a surgical plan for the patient called "Da Vinci robot assisted total laparoscopic ileal ureteral replacement". At the same time, considering the combination of bladder and lumbar muscle suspension during surgery, the length of intestinal use should be minimized as much as possible, which can reduce the adverse complications caused by intestinal absorption in the later stage.
During the surgery, Director Liu Yidong and Dr. Lv Xiangguo used the da Vinci surgical robot to carefully free the patient's affected ureter. At the same time, the bladder psoas major muscle was used for suspension, and after measuring the length of the defect, a 15 centimeter ileum was removed from the patient to replace the ureter. The ureter intestinal bladder anastomosis was successfully completed, completely solving the problem of ureteral stenosis that troubled the patient.
![How to transform the intestine into the ureter? Da Vinci Surgical Robot Assists "Graft" Bracelet | Ureter | Robot](https://a5qu.com/upload/images/46d42cef21df5d911447d98d723b6982.jpg)
Liu Yidong explained that in the past, such patients often used the ileum to replace the entire ureter, and with this improved technique, the length of the ileum can be reduced. In addition, for patients with renal insufficiency, it is possible to reduce the disruption of the internal environment caused by intestinal absorption. Under full endoscopy, the replacement of the ureter with the intestine can reduce the occurrence of intestinal contracture caused by a decrease in temperature after the intestine is removed from the body, and the wound size is smaller, resulting in faster postoperative recovery for patients.
Surgical robots are widely used to benefit patients
Surgical robots are widely used, benefiting patients
Ureteroplasty surgery requires a high level of suturing skills from doctors, and a slight lack of attention may lead to urinary leakage and stenosis, which can affect the surgical outcome. With the development of technology, minimally invasive surgery has gradually become the mainstream method in upper urinary tract reconstruction surgery.
In top-level and complex ureteral repair surgeries, it is difficult to remove and suture, and the emergence of da Vinci robots has made these difficulties easily solved. Not only does it reduce intraoperative bleeding, alleviate postoperative pain, and shorten hospital stay, but it also maintains the advantages of minimally invasive surgery and provides high-definition three-dimensional visual effects, breaking through the limitations of the human eye.
In addition, the robotic arm of the robot is more flexible, has a greater degree of rotation, and can work in narrower spaces, while avoiding the instability of human operation. This precise operation is not only applied in the field of tumor treatment, but also plays a huge advantage in the fields of reconstruction and repair. It is reported that robot surgery has definite advantages in the repair and reconstruction of complex ureteral strictures, such as resection of the lower segment of the ureter for ureteral bladder replantation, resection of the narrow segment of the ureter for mucosal reconstruction of the ureter, and use of appendix patches for ureteroplasty of the upper and middle segments of the right ureter, all of which have achieved satisfactory therapeutic effects.
![How to transform the intestine into the ureter? Da Vinci Surgical Robot Assists "Graft" Bracelet | Ureter | Robot](https://a5qu.com/upload/images/1babb983814c9c5bcda3031924e2d748.jpg)