Video manuscript submission for single port robotic right retroperitoneal ureteroureterostomy

Introduction: Recurrent nephrolithiasis, prior endoscopic surgeries, or iatrogenic injury can result in ureteral strictures. Different reconstructive options may be offered depending on the length, location, and etiology of the stricture. Single port retroperitoneal robotic surgery has gained popularity for its ability to work in narrow spaces, improved cosmesis, and expedited recovery. Methods: The patient is a 58-year-old male with a history of recurrent nephrolithiasis, managed with multiple prior surgical interventions who subsequently developed a 1 cm right mid-ureteral stricture and has failed endoscopic management. He has bothersome intermittent right flank pain and is interested in surgical reconstruction. After thorough work-up and discussion of risks and benefits, the decision is made to proceed with single-port robotic right retroperitoneal ureteroureterostomy. The step-by-step surgical technique is demonstrated in the video. Results: The patient did well post-operatively and was able to be discharged home on post-operative day 1. He had his ureteral stent removed 4 weeks after surgery and repeat imaging 8 weeks after surgery showed no resolution of his obstruction. The patient is no longer experiencing intermittent right flank pain and is very satisfied with his results. Conclusion: This case demonstrates the successful application of single-port robotic retroperitoneal ureteroureterostomy in a patient with a mid-ureteral stricture. As robotic technology advances, single-port approaches may continue to evolve as a preferred option for reconstructive urologic surgeries; however, further research and long-term follow-up are necessary to establish the durability and reproducibility of this technique.