Robot-assisted reconstruction using ureteroureterostomy and Lich–Gregoir ureteral reimplantation for complicated duplex kidneys in children

by Huazhang Liu, Chang Tao, Xiang Yan, Guangjie Chen, Guangping Zeng Objective This study aimed to evaluate the efficacy of robot-assisted reconstruction using end-to-side ureteroureterostomy (UU) and Lich‒Gregoir ureterovesical reimplantation (UR) for complicated duplex kidneys in children. Methods A retrospective study was conducted on pediatric patients who underwent combined robotic UU and Lich‒Gregoir UR between January 1, 2021, and January 1, 2024.

The inclusion criterion was the presence of concurrent upper- and lower-pole ureteral pathologies. Surgical time, postoperative length of stay, pre- and postoperative anteroposterior diameter of the renal pelvis (APD), ureteral diameter (UD), renal function (RF) of the affected kidney, and complications were analyzed.

Results In total, 12 patients presented with urinary tract infections (UTI, n = 9), incontinence (n = 2), and abdominal pain (n = 1). Upper-pole pathologies included ectopic ureters (10 cases) and ureteroceles (2 cases).

Lower-pole pathologies comprised ureteral stricture (n = 4) and vesicoureteral reflux (VUR, n = 8). The median surgical time was 177.5 minutes (range: 140–205 minutes), and the median hospital stay was 5 days (range: 3–7 days).