Abstract：Objective: To introduce our technique and experience in 12 cases of robot-assisted laparoscopic ureteral reimplantation with method of psoas hitch and clinical outcomes. Methods: The clinic data of 12 patients with middle or distal ureteral stricture and hydronephrosis from June 2013 to March 2015 were analyzed retrospectively. Ten cases were in the left side and 2 cases in the right side. The middle or distal ureteral strictures were diagnosed with ultrasonography and intravenous urography angiography, with average diameter of 1.8 (0.6-2.6) cm in ureteral expansion and pyelectasis 2.56 (1.3-3.9) cm. All of the patients underwent robot-assisted laparoscopic ureteral reimplantation with psoas hitch procedure (submucosal tunnel ureteral reimplantation in 3 cases and ureteral nipple ureteralreimplantation in 9 cases). Results: All of the operations were performed successfully without conversions to open surgery. The mean operating time was 131 (80-185) min, including the preoperative set-up time of da Vinci surgical system about 25 min. The mean estimated blood loss was 51 (30-100) mL. The drainage tubes of all cases were removed 4.2 (3-7) days after surgery without urine leakage. The urinary catheters were removed 6.2 (5-7) days after surgery. The hospital stay was 7.8 (5-9) days. The double-J stents were removed 27.4 (25-32) days after surgery. During 6 to 15 months follow-up, ultrasonography and IVU showed mild hydronephrosis in 2 cases and no obvious hydronephrosis in 10 cases. There was no obstruction or vesicoureteral reflux in any case.Conclusions: Robot-assisted laparoscopic ureteral reimplantation with methods of psoas hitch is technically effective and reliable in treating middle or distal ureteral obstruction.
