Presented by: Sophia Hook
Sophia Hook

Introduction

Boari bladder flap plasty is the method of choice for reconstructing distal and mid ureteral strictures. In this study we compare the perioperative outcomes of open and robotic-assisted laparoscopic Boari bladder flap plasty.

Materials

This study aimed to retrospectively analyse intra- and postoperative course after open (2018 - 2020) and robotic-assisted (2021 - 2022) Boari bladder flap plasty. The open Boari bladder flap plasty was always performed extraperitoneally. The robotic-assisted Boari bladder flap plasty was performed through a transperitoneal approach using the 4-arm DaVinci X system in a side docking technique. No psoas bladder hitch was performed. In both the open and robotic-assisted surgeries a DJ stent and a urethral catheter were inserted intraoperatively.

Results

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Total of 9 patients underwent open Boari bladder flap plasty and 6 patients underwent robotic-assisted Boari bladder flap plasty. The preoperative characteristics of the patients did not differ significantly. Preoperative renal function did not differ between the two groups (Mean GFR: 71.3 (±19.2) vs. 77.8 (15.3) ml/min; n.s.). The operating time did not differ significantly (Mean 122 ± 12 vs. 129 ± 39 min; n.s.). There was no significant blood loss in either group and no significant intra- or postoperative complications occurred. The mean length of hospital stay was 9.9 days for open (±3.8) vs. 6.0  days (± 2.0) for robotic-assistend surgery (p=0.045). Postoperative renal function did not differ between the two groups (Mean GFR: 78.3 (±17.4) vs. 87.2 (5.1) ml/min; n.s.).

Conclusion

Robotic-assisted Boari bladder flap plasty is a safe alternative to open surgery. The hospital stay is shorter for robotic-assisted surgery.

Funding

None

Lead Authors

Holger Böhme, MD
Asklepios Klinik Barmbek

Christopher Netsch, MD
Asklepios Klinik Barmbek

Benedikt Becker, MD
Asklepios Klinik Barmbek

Andreas J. Gross, MD
Asklepios Klinik Barmbek

Clemens Mathias Rosenbaum, MD
Asklepios Klinik Barmbek