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Recently, Ms. Zheng, a patient with complex ureteral stenosis, frequently replaced stents, which seriously troubled her life. With the help of Xu Yan’s surgical team from the Urology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine, a section of the patient’s “intestine” was used to replace the ureter with the help of the Da Vinci surgical robot. Completely solve the problem of full-length ureteral stricture. high precision cheap price Professional OEM Custom engle dental systems
Ureteral stenosis after tumor surgery, frequent stent replacement is painful
The patient, Ms. Zheng, was diagnosed with endometrial cancer three years ago. She underwent a “hysterectomy” in the hospital and cooperated with postoperative radiotherapy. During the recovery process, Ms. Zheng gradually developed right abdominal pain. She went to the local hospital for examination and found right hydronephrosis and right ureteral stenosis. In order to protect the kidney function and alleviate the problem of hydronephrosis, Ms. Zheng received the right ureteral stent implantation. Ureteral stent implantation is a common treatment for hydronephrosis caused by obstruction, but the ureteral stent should not be stored in the body for too long , it needs to be replaced regularly. In the past three years, the ureteral stent has been replaced every 2-3 months, which has brought serious troubles to the young Ms. Zheng.
In the past six months, Ms. Zheng often experienced low back pain, fever, frequent urination, and painful urination after ureteral stent replacement. Although the related symptoms were controlled through treatment, repeated ureteral stent replacement often increased the risk of infection. It can be said to be “treating the symptoms but not the root cause”. high precision cheap price Professional OEM Custom engle dental systems
After many inquiries, Ms. Zheng learned that the surgical team of Professor Xu Yan from the Urology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine has rich experience in the treatment of ureteral stenosis, so she came to the hospital, hoping to solve the problem of ureteral stenosis through surgery.
After the operation, Ms. Zheng recovered well and was discharged from the hospital.
A section of ileum was removed, and the surgical robot assisted in precise repair
After receiving the patient, Professor Xu Yan, the director of the department, led the surgical team to complete the preoperative series of examinations for Ms. Zheng. Through the antegrade-retrograde angiography of the right urinary system, it was found that the patient’s right ureter was near the junction of the renal pelvis and the lower ureter. The stenosis is about 20m. “Generally, the ureter of an adult is about 22cm to 27cm. We found that the patient Ms. Zheng already had a stenosis of almost the full length of the ureter based on the results of multiple imaging examinations. This actually brought great difficulties to the follow-up surgery. Difficulty and challenges.” Xu Yan, director of the department, said.
Ureteral stricture is a common urological disease. One of the most common causes is ureteral injury. If the diagnosis of ureteral injury is not timely or handled properly, it will lead to serious complications such as urinary fistula, ureteral stricture, hydronephrosis and renal failure. Many patients have to take tubes for life at a young age. high precision cheap price Professional OEM Custom engle dental systems
Director Xu Yan introduced that the treatment of ureteral injury depends on various factors such as the time of diagnosis, the location and degree of injury, and the treatment covers various repair methods from endoscopic treatment to reconstruction with substitutes. The treatment of upper and middle ureteral strictures includes a variety of endoscopic treatment and ureter reconstruction; the upper and middle ureteral stenosis of <2cm is suitable for endoscopic incision or dilation of ureteral stenosis; Stenosis is suitable for end-to-end ureteral anastomosis; ureteral stenosis of more than 3 cm used to be performed by permanent nephrostomy, intestinal replacement of ureter, and autologous kidney transplantation. The latter two operations are complicated and risky.
After clarifying the position and length of the patient’s right ureteral stenosis, Director Xu Yan held a discussion on difficult cases in the department. After comprehensive consideration, the team finally formulated a surgical plan for the patient Ms. Zheng to “replace the full-length ureter with the ileum”. At the same time, with the help of the Da Vinci surgical robot, Director Xu Yan delicately and carefully dissociated the right ureter of the patient, and removed the patient’s 25cm ileum to replace the full-length ureter. With the fine anastomosis of the surgical robot, the anastomosis of the ileum replacing the ureter to the bladder segment and the ureteropelvic anastomosis were successfully completed. , completely solved the problem of ureteral stenosis that has plagued Ms. Zheng for a long time. high precision cheap price Professional OEM Custom engle dental systems
Not only the “intestines”, but also the “skin” in the mouth can replace the ureter
In addition to inheriting the advantages of minimally invasive laparoscopic surgery, the da Vinci surgical robot can adjust the field of view at any time according to the operator’s intention; the high-resolution naked-eye three-dimensional image magnified by nearly ten times, and the surgical instruments are more flexible than human hands. Multiple freedom of movement It is convenient for surgeons to perform tissue positioning and instrument operation more precisely and meticulously. It expands the operating ability of the operator, improves the accuracy of the operation, and it is no longer difficult to operate fine surgery in a small space.
Director Xu Yan introduced that for urology, the da Vinci robot is very useful. For surgeries such as radical prostatectomy, since the prostate is located in the deepest part of the pelvic cavity and the space is narrow, Da Vinci robotic surgery has obvious advantages over ordinary laparoscopic surgery in terms of tumor control, urinary control, and nerve preservation; another example Resection of kidney-preserving renal tumors requires precise dissociation of renal arteries and veins and careful suturing of renal parenchymal wounds. These are the great advantages of the Da Vinci surgical robot. In addition, surgical robots also have advantages in urological surgery for urinary tract reconstruction and reconstruction. Compared with the difficult deep reconstruction and anastomosis under ordinary laparoscopy or even open surgery, the operation assisted by robots is less in terms of suture quality and suture time. have more advantages. high precision cheap price Professional OEM Custom engle dental systems
At present, ureteral reconstruction surgery for upper ureteral stenosis larger than 3 cm is a big problem at home and abroad, with high surgical difficulty and high risk of recurrence. “The Urology Department of the Provincial Hospital of Traditional Chinese Medicine has taken advantage of the Da Vinci surgical robot, and has carried out many difficult ureteral and urinary tract reconstruction operations in which the oral buccal mucosa replaces the ureter and the ileum replaces the ureter.” Director Xu Yan explained that this replacement of the ureter Revision surgery, in simple terms, is to select an appropriate small piece of “skin” from different parts of the intestine, bladder, appendix, or even oral buccal mucosa, tongue mucosa, and lip mucosa according to the patient’s own conditions, stenosis, and tissue blood supply. , as a repair patch, sutured into a ureteral style, replacing the patient’s narrow ureter, repairing and expanding the ureteral cavity, although the surgical suture is very difficult, the damage is small and the surgical effect is relatively significant. high precision cheap price Professional OEM Custom engle dental systems