Robotic ureteric reimplantation for benign disease in a tertiary UK centre: safe and effective.

OBJECTIVE

Robotic ureteric reimplantation is increasingly utilised for benign distal and mid-ureteric pathology. However, medium-term outcomes remain underreported, particularly in UK practice, and optimal follow-up uncertain. We aimed to evaluate the safety and efficacy of robotic ureteric reimplantation for benign indications and inform optimal follow-up strategies.

METHODS

Retrospective review of 67 patients undergoing robotic ureteric reimplantation at a tertiary UK centre between 2016 and 2023. Primary outcomes included postoperative obstruction and need for long-term urinary drainage. Secondary outcomes were post-operative complications, change in renal function, and hospital stay. Descriptive statistics and paired t-tests were used. KEY FINDINGS AND LIMITATIONS: Sixty-seven patients (40 females, 27 males) underwent robotic ureteric reimplantation for benign disease. Causes were urological (54%) and gynaecological (45%), mostly operative injuries. Techniques included Lich-Gregoir (n = 56), psoas hitch (n = 5), and Boari flap (n = 6). One case was converted to open surgery at the start of the learning curve. Median hospital stay was 2 days. Mean follow-up was 709 days. Four patients (6%) showed radiological obstruction; three required further intervention. Renal function remained stable (mean creatinine change − 2 ± 12.5 mmol/L, p = 0.07). Eleven patients experienced Clavien-Dindo grade II complications. One patient with prior radiotherapy required cystectomy for a poorly compliant bladder. CONCLUSIONS AND CLINICAL IMPLICATIONS: Robotic ureteric reimplantation for benign disease is safe and effective. Most complications occur within the first year, and long-term monitoring is recommended in select cases including radiation cases.