用達文西腹腔鏡治療輸尿管狹窄
殷約翰、郭敏勇2、童敏哲1,2
童綜合醫院 外科部2 泌尿科1
Management of ureteral obstruction with davinci laparoscopic surgery
Jue-Hawn Yin, Min-Yung Kuo2, Min-Che Tung1,2
Divisions of Urology1, Department of Surgery2, Tungs’ Taichung Metroharbor Hospital
Purpose: It is difficult to use the two-dimentional imaging conventional laparoscopic surgery for dissection, suturing , and knot-tying.With the advent of three-dimentional imaging and wide range freedom of movement of the instruments , the robotic laparoscopic surgery may overcome these obstacles and improved the laparoscopic technique. In past two years , we used daVinci laparoscopic surgery for ureteral obstruction due to various underlying disease.
Materials and Methods: In recent two years, we operated on a total of 4 cases of ureteral obstruction. The underlying causes of ureteral obstruction including one complete duplication of ureter, one recurrent UPJO, one duplex renal pelvis with obstruction, one endometriosis with recurrent lower third ureteral obstruction. There are three female and one male patient, age ranged 23 to 30. The daVinci robotic laparoscopic surgery was used to ureterolysis, segmental resection and reanastomosis of the ureter. The methods we used are dismembered pyeloplasty and transureteroureterostomy.
Results: We followed up these case from 4 months to 15 months. The ureteral anastomosis healed well. All of the obstructions were alleviated.
Conclusions: The daVinci laparoscopic surgery is a useful method to treat ureteral obstruction. No matter it was caused by congenital disease, recurrent disease or inflammatory disease. The meticulous approach to upper or lower ureter is easy and less traumatic. The anastomosis healed well.