機械手臂輔助口腔黏膜移植片輸尿管整形術治療輸尿管狹窄-個案報告
陳柏諺、羅浩倫、江博暉
高雄長庚紀念醫院 泌尿科
Robotic assisted ureteroplasty with buccal mucosa graft for the treatment of ureteral stricture–case report
Po Yen Chen, Hao Lun Lo, Po Hui Chiang
Department of Urology, Kaohsiung Chang Gung Memorial Hospital
We present a case of 60 years old female patient who received 3 times ESWL and 3 times ureteroscopic stone manipulations from 2016 to 2017. She visited our outpatient clinic due to progressive left flank pain. CT revealed a long segment stricture (3.0cm) of left middle ureter with moderate to severe hydronephrosis.
Robot assisted ureteroureterostomy was supposed to be performed. However, local adhesion and long segment stricture was found during operation. Therefore, robot assisted ureteroplasty with buccal mucosa graft was done. Autologous buccal mucosa graft 1.5x 3.5cm was harvested. Incision over the stenotic segment was performed. The buccal mucsal graft was sutured over the stenotic area with an onlay method. Absorbable suture was performed after the placement of a double J stent. The stent was removed 1 month later. Renal echo and IVP showed complete regression of the hydronephrosis three months after the operation.
In the era of robotic surgery, the buccal mucosa can be used to repair the ureteral stricture successfully.