ESPU Congress 2018 - Abstract Book

122 29 th CONGRESS OF THE ESPU 09:31–09:34 S14-9 (PP) SINGLE INSTITUTION EXPERIENCE AND TECHNIQUE FOR ROBOTIC-ASSISTED LAPAROSCOPIC DISMEMBERED URETERAL REIMPLANTATION Arun SRINIVASAN, Jay SHAH, Diana BOWEN, Jason VAN BATAVIA, Yves BODAR, Christopher LONG and Aseem SHUKLA Children's Hospital of Philadelphia, Urology, Philadelphia, USA PURPOSE Robotic assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) can be utilized for primary obstructive mega-ureter (POM) or ureters associated with diverticula. We hypothesize that RALUR-EV approach is feasible and effective for dismembered reimplant with or without tapering and tailoring of ureter. MATERIAL AND METHODS All patients undergoing robotic surgery at our institution are prospectively entered into an IRB ap- proved registry. We retrospectively reviewed patients who underwent dismembered RALUR-EV from April 2009 to August 2017, and had at least one post-operative ultrasound. Inclusion criteria included POM, ureter associated with a bladder diverticula, distal ureteral stricture, or high grade VUR. Patient demographics and outcome variables analyzed included age, gender, ureteral stent placement, length of hospital stay (LOS), urinary tract infection (UTI), and complications by Clavien grade. RESULTS 25 patients (17 male, 8 female) had dismembered RALUR-EV with a median age of 4 years (IQR 1.4,8.5) and median follow up of 11.6 months (IQR 5,33). Diagnoses included POM in 13 patients (52 %), UVJ obstruction in 6 (24 %), diverticulum in 4 (16 %) and high grade VUR in 2 (8 %). Median operative time for RALUR-EV without tapering was 230 minutes (IQR 191,270; n=22) compared with RALUR-EV with tapering which was 250 minutes (IQR 195,461; n=3). Median LOS was 2 days. Ureteral stenting was used in 22 patients (88 %) for a median of 6 weeks (IQR 4,8.5). 3 patients (12 %) developed febrile UTIs when they had stents in place and 4 (16 %)developed febrile UTIs after stent was removed. There were no other complications. Postoperatively RBUS has shown significant improvement in all patients with one patient having new vesicoureteral reflux diagnosed after urinary tract infection. CONCLUSIONS Robot assisted laparoscopic approach for dismembered reimplantation with or without ureteral tailoring yields excellent results and is comparable to other approaches. 09:34–09:46 Discussion