Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

VR-18

(VS)

ROBOTIC ASSISTED REMOVAL OF SYMPTOMATIC URETERAL STUMP, ECTOPIC

INTO SEMINAL DUCTS

Mario DE GENNARO

, Giovanni TORINO

, Maria Luisa CAPITANUCCI

, Giovanni MOSIELLO

and Antonio ZACCARA

1) Children's Hospital Bambino Gesu', Dep. Urology and Nephrology. Urology, Robotic Surgery and Urodynamics Unit,

Roma, ITALY - 2) Children's Hospital Bambino Gesu', Dep. Urology and Nephrology, Roma, ITALY - 3) Children's Hospital

Bambino Gesu', Dep. Urology and Nephrology, Roma, ITALY

PURPOSE

Advanced technology allows safer and more complete surgical procedures. We describe a case where robotic-assisted

laparoscopy avoided extensive surgery.Nephroureterectomy is generally uneventful, even if you leave the ureteral

refluxing stump. Ureteral ectopia into the seminal ducts is extremely rare, but it may present in adolescents with

recurrent febrile epididymitis

MATERIAL AND METHODS

A 14 years old boy, who underwent right nephroureterectomy at one year leaving its ureteral stump, presented with

abdominal symptoms (fever, pain) and suspected appendicitis, but ultrasound showed fluid collection in the stump, and

he recovered after antibiotic therapy. Recurrent epididydimitis occurred during the following 3 years, thus decision was

taken to remove the ureteral stump

RESULTS

Following cystoscopy confirming absent right ureteral meatus, robotic-assisted retrovesical exploration of the pelvis

allowed to find the ureteral stump, to explore deeply to the seminal ducts, and to entirely remove the stump. We used a

30° robotic camera, with two trocars positioned as for radical prostatectomy, and a supplementary laparoscopicone. The

procedure required 2.5 hours, the total hospital staying was 44 hours, without any postoperative pain, but little vesical

symptoms due to endoscopy.

CONCLUSIONS

This is the first case described of ectopic stump removed by robotic-assisted surgery. The procedure allowed complete

and safe removal of the stump, in an anatomic (retrovesical, anterectal) position, challenging to be reached by open

surgery, and potentially requiring a transrectal approach. Robotic surgery permits not only minimally invasive surgery,

but also to enter in anatomical areas difficult to reach.