Robotic Ureteropyelostomy in A 10 Month Child With Complete Duplex Kidney With Ectopic Ureter

Introduction

Renal duplication anomalies are common in children with varied presentation. In children with well-functioning obstructed moieties, preservation of renal parenchyma by common sheath reimplantation, uretero-pyelostomy, ureteroureterostomy is the standard treatment.We present a left complete duplex kidney with ectopic ureter managed robotically in an infant.

Background

Ten months old male child presented with recurrent UTI with a history of left antenatal hydronephrosis.

Diagnosis

On evaluation, he was found to have complete left duplex kidneys with upper moiety moderate hydro-ureteronephrosis with ectopic insertion into prostatic urethra with good parenchyma and excretion on CT Urogram. MCUG showed low grade reflux into lower moiety. DMSA scan showed reduced upper moiety function.

Robotic left-sided Uretero-Pyelostomy was done. Dilated upper moiety ureter was transected and anastomosed to lower moiety pelvis in end to side fashion. DJ stent was placed across the anastomosis into the upper moiety ureter. Post operative period was uneventful and the stent was removed after 6 weeks.

Conclusion

We believe that the upper tract robotic reconstruction is feasible in the infants and it is a safe option.

About Author –

Dr. V. Surya Prakash ,Consultant Urologist, Laparoscopic, Robotic & Transplant Surgeon

MS (Gen Surgery), FRCSED, M.Ch(Urology), DNB(Urology), D.Lap

About Author –

Dr. K.Seshu Mohan, Consultant Urologist, Yashoda Hospital, Hyderabad
MS, M.Ch (Urology)