13288 Robotic Repair of a Large Left Ureterocele with Ureteral Reimplantation Using a Boari Flap

This video demonstrates the intraoperative diagnosis and surgical repair of a large left ureterocele, followed by reimplantation using a Boari flap. Preoperatively, the ureterocele was misidentified as a pelvic cyst near the ureter. An educational video demonstrating the process of robotic-assisted laparoscopic ureterocele repair. Community hospital with narrated approach to the procedure. A 32-year-old patient with a history of dysmenorrhea and dyspareunia was found to have a 9 cm mildly complex left ovarian cyst on pelvic ultrasound. She underwent a diagnostic laparoscopy, which revealed a large left retroperitoneal cyst that was incised and drained. Despite the procedure, she continued to experience generalized abdominal pain, and a follow-up MRI confirmed the presence of a persistent 9 cm left paraovarian cyst. She subsequently underwent a robotic-assisted excision of endometriosis and the left-sided retroperitoneal pelvic cyst. Intraoperatively, the cyst was identified as a large left ureterocele. Urology proceeded with a robotic-assisted excision of the ureterocele, followed by left ureteral reimplantation using a Boari flap. This video showcases a ureterocele repair performed using minimally invasive robotic techniques, which enhance precision, ergonomics, and visualization for improved surgical outcomes. NA Ureteroceles in adults are rare and often misdiagnosed as other pelvic pathologies, particularly in reproductive-aged women. Once accurately identified, surgical management should prioritize minimally invasive techniques. When feasible, a robotic-assisted approach is preferred, as it enhances precision, improves visualization, and ultimately leads to better surgical outcomes.