Robotic Extravesical Reimplant

Robotic extravesical reimplant with small diverticula

Not infrequently, small diverticula are seen associated with vesicoureteral reflux on the voiding cystourethrogram:

Cystoscopically, a true diverticula is not seen. This suggests the distal ureter insertion lacks detrussor muscle support which allows the mucosa to evert.

An extravesical robotic reimplant can be done without excision of the “diverticula” since the reimplant itself fixes the lack of distal ureter muscle support.

The technique is shown in this video: