Identify indications for upper urinary tract reconstruction, and appropriate patient selection for robotic surgery.
Identify optimal patient positioning, operating room setup, port placement, and general robotic surgical principles.
Identify techniques to preserve blood flow, minimize tension, and create a water-tight anastomosis.
Review imaging techniques to diagnose and localize ureteral strictures.
Identify and manage intraoperative and postoperative complications of robotic upper tract reconstructive surgery.
This course aims to teach participants how to apply robotics to perform complex upper urinary tract reconstruction. We will teach the participants with standardized techniques for pyeloplasty, ureteroureterostomy, ureteroplasty and ureterolysis. Multiple techniques of ureteral reimplantation will also be demonstrated: refluxing, non-refluxing, extravesical, intravesical and Boari flap. We will describe techniques such as downward nephropexy, psoas hitch and omental flap to complement these techniques. Urinary reconstruction in the context of unusual anatomy will also be discussed, including management for horseshoe kidney, retrocaval ureter, ureteral duplication, ectopic and malrotated kidneys, and retroperitoneal fibrosis. Advanced reconstructive procedures will be demonstrated, such as revision of uretero-intestinal anastomoses and buccal mucosa graft for long-segment ureteral strictures. Tips and tricks will be given, including efficient methods of stent placement, and ureteral localization using advanced imaging techniques and intraureteral indocyanine green (ICG). Preoperative planning, operative technique, postoperative management and complications will be reviewed in a systematic fashion. Both multiport and single-port approaches will be demonstrated. The course will rely heavily on video-based learning. The course faculty will include 4 internationally known high volume robotic surgeons, all with an expertise in upper urinary tract reconstruction.