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29
th
CONGRESS OF THE ESPU
10:34–10:39
S15-4 (VP)
ROBOT-ASSISTED RESECTION OF ECTOPIC KIDNEY: SAFE
AND EFFECTIVE
Achilles PLOUMIDIS
1
, Marjan WATERLOOS
2
, Athanasios PAPPAS
1
, Steven
WEYERS
3
, Piet HOEBEKE
2
and Anne-Françoise SPINOIT
2
1) Athens Medical Centre, Urology, Athens, GREECE - 2) Ghent University Hospital, Urology, Ghent, BELGIUM -
3) Ghent University Hospital, Gynecology, Gent, BELGIUM
PURPOSE
Failure of migration of the kidney during early embryonic life results in an ectopic kidney, with an
incidence varying from 1/500 to 1/1200.
This video illustrates robotic resection of ectopic pediatric kidney.
MATERIAL AND METHODS
A 7-years-old girl was referred to our center with a history of recurrent urinary tract infections with
vaginal discharge. Ultrasound demonstrated a unique orthotopic kidney on the right-hand side,
confirmed by DMSA scan showing 100 % of function right. Additional imaging was realized with
a T2-weighted magnetic resonance imaging showed a dysplastic ectopic kidney located in the
pelvis, with ureter draining into the vaginal wall.
RESULTS
The patient was positioned in a classical robot-adapted lithotomy position, with indwelling bladder
catheter. The camera-trocar was placed in the umbilicus and two additional 8 mm ports were in-
serted at the mid-clavicular line bilaterally, with an additional 5 mm port on the left-hand side. A side-
docking position was adopted, allowing thereby further cystoscopic and vaginosopic evaluation
during the procedure. A uterus bicornis was found, with a normal vaginal opening for the age. After
opening of the peritoneum medially from the internal iliac vessel, the ectopic kidney was progres-
sively dissected. The ectopic ureter was dissected towards it drainage in the vaginal wall, where
it was sutured and resected. The dysplastic kidney and ureter were removed trough the right iliac
port. Dissection deep into the pelvis towards the vaginal wall is aided by the robotic dexterity and
facilites complete resection of the structure, avoiding to leave an ureteric stump into the vaginal wall.
The postoperative period was uncomplicated, and the child could be discharged on the first day
after surgery.
CONCLUSIONS
Robot-assisted surgery is a safe and effective for resection of ectopic kidneys with ectopic ureter.
Dissection up until the vaginal wall in children is aided by robotic dexterity.