Volume 17, Issue 4 e13375
OPERATIVE TECHNIQUE

The urinary tract reconstruction in a robot-assisted surgery for rectal malignancy with combined prostate and seminal vesicle resection

Ryo Iguchi

Corresponding Author

Ryo Iguchi

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

Department of Urology, Kyoto Katsura Hospital, Kyoto, Japan

Correspondence

Ryo Iguchi, Department of Urology, Kyoto Katsura Hospital, 17 Yamada Hirao-Cho, Nishikyo-Ku, Kyoto 615-8256, Japan.

Email: [email protected]

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Mitsuru Yokota

Mitsuru Yokota

Department of General Surgery, Kurashiki Central Hospital, Kurashiki, Japan

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Kenji Kawada

Kenji Kawada

Department of General Surgery, Kurashiki Central Hospital, Kurashiki, Japan

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Tomoki Ohnishi

Tomoki Ohnishi

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Naoya Kani

Naoya Kani

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Yuta Mine

Yuta Mine

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Iori Matsuda

Iori Matsuda

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Yusuke Hama

Yusuke Hama

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Kyohei Sugiyama

Kyohei Sugiyama

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Akito Terai

Akito Terai

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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Koji Inoue

Koji Inoue

Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan

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First published: 18 August 2024

Abstract

Introduction

In certain cases of rectal malignancy in which invasion is confined to the prostate and/or seminal vesicles, bladder-sparing surgery may be chosen instead of total pelvic exenteration. However, even if the bladder is preserved, postoperative urinary dysfunction and vesicourethral anastomotic leakage are concern.

Materials and Surgical Technique

We employ various techniques based on robot-assisted radical prostatectomy for reconstructing the urinary tract. These techniques include advanced reconstruction of vesicourethral support, total anatomical reconstruction, and a method called anterior reconstruction. In addition, suture fixation of bladder to the anterior abdominal wall, and re-approximation of bladder by peritoneal suture were done.

Discussion

Reliable robot-assisted vesicourethral anastomosis and reinforcement of the anastomotic wall could potentially enhance the self-voiding rate and decrease the risk of anastomotic failure.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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