Recurrent ureteral pelvic junction (UPJ) obstruction is a challenging surgical problem. Ureteral devascularization, fibrosis with renal fixation and dense stricture formation interfere with our ability to create a tension-free anastomosis. A high rate of recurrence leads to progressively complex repairs.
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Robotic salvage pyeloplasty with buccal mucosal graft (BMG) is a potentially more effective approach when compared to more extensive and invasive procedures.
In this video, Cleveland Clinic Glickman Urological & Kidney Institute urologists perform robotic salvage pyeloplasty with BMG for two patients with recurrent left UPJ obstruction. The result is a tension-free, watertight, patent repair in both patients, who previously endured multiple failed pyeloplasties. It is an attractive alternative technique in the management of recurrent UPJ obstruction.
The video, produced by Georges-Pascal Haber, MD, PhD; Anna Zampini, MD, MBA, MS; Ryan Nelson, DO; Jeremy Reese, MD, MPH, M.Ed., and Kenneth Angermeier, MD, from the Urological & Kidney Institute, was presented at the American Urological Association’s 2017 annual meeting.