Robot-assisted laparoscopic ureteroureterostomy: Description of technique

Background and Purpose: With the development of robotic assistance, laparoscopic surgery has evolved over the past few years. Smaller instruments, better visibility, and growing surgical experience have allowed more complex reconstructive procedures to be performed laparoscopically. Herein, we describe our technique and experience in robot-assisted laparoscopic ureteroureterostomy (RALU) for the correction of ureteral obstruction in children. Technique: RALU was performed in three children through a transperitoneal approach utilizing three ports. We describe our preference for patient positioning, robotic set-up, port placement, the use of a "hitch stitch," and the option of placing a fourth port. Conclusions: RALU is a reliable and efficient technique for the correction of ureteral obstruction in children and can be applied to any pathology that requires ureteral reconstruction, regardless if it is a duplicated or a single system.