Robotic Surgery and Reconstruction

Urologic Reconstruction with Robotic Surgery

Dr. Osterberg has received extensive training in robotic-assisted laparoscopic surgery. He has trained with early pioneers of robotic surgery who have perfected robotic techniques for radical prostatectomy and radical cystectomy. Using the robotic training he learned from cancer operations, Dr. Osterberg now utilizes robotic surgery for complex urologic reconstruction. He believes that robotic surgery in urologic reconstruction allows for more precise surgery, a quicker recovery time, and less blood loss.

DaVinci Xi Robotic Console

Conditions Treated with Robotic Surgery

Ureteral Stricture. A narrowing of the drainage tube from your kidney is called a ureteral stricture. This may be due to prior surgery, radiation, or even prior infections. Regardless of the cause, a narrowing of the ureter may lead to hydronephrosis or swelling of the kidney. Long-term kidney swelling can ultimately lead kidney damage. The goal of robotic ureteral surgery is to facilitate drainage of urine from your kidney back to your bladder. This is performed by re-routing the ureter and/or pulling the bladder up to a healthy portion of ureter. Alternatively, the scarred portion of the ureter may be excised and the two good ends may be reconnected. Dr. Osterberg will review your images and work with you to determine which operation best suits.

UreteroEnteric Strictures. Patients who have a history of bladder cancer may have had their bladders removed and reconstructed out of their own intestines. This is called a urinary diversion. Occasionally, the connection between the tube that drains the kidneys (called the ureter) and the intestine can develop a scar or narrowing. This narrowing leads to difficulty draining urine from the kidney. Over time, the kidney can develop swelling, and this may lead to kidney failure. In order to fix the scar, Dr. Osterberg may have to perform a reimplantation procedure between healthy ureter and your urinary diversion. This is called a uretero-enteric anastomosis. This type of reconstruction can be done robotically in a minimally invasive fashion.

Instructional video of robotic assisted distal ureterectomy and reimplantation by Dr. Osterberg and colleagues