The Asian Institute of Nephrology & Urology (AINU), Vizag, has successfully performed Vizag’s first robotic Boari flap reconstruction surgery to treat a complex long-segment ureteric stricture in a 50-year-old woman from Kakinada, Andhra Pradesh. The procedure restored normal urinary flow and helped preserve kidney function.
Managing a Complex Ureteric Stricture
The patient initially presented with a ureteric stone that could not be treated at another hospital because of significant ureteric narrowing. She subsequently developed urinary obstruction and infection.
At AINU, doctors first placed a percutaneous nephrostomy (PCN) tube to relieve the obstruction and control the infection. Although the stone was later removed, recurrent infections continued because of the long-segment ureteric stricture, leaving her dependent on external drainage. The urology team subsequently opted for robotic reconstruction to restore normal urinary flow.
Robotic Reconstruction Enables Precise Treatment
During surgery, the team found a more extensive ureteric defect than expected, making conventional procedures such as ureteric reimplantation or psoas hitch unsuitable. Therefore, surgeons performed a robotic Boari flap reconstruction, using bladder tissue to reconstruct the damaged ureter.
As per the press release, the minimally invasive robotic approach reduced surgical trauma, blood loss and postoperative pain while enabling faster recovery. The patient recovered well, had the kidney tube removed before discharge and left the hospital within three days.
Expertise in Robotic Urology
Dr. Amit Saple, Senior Consultant Urologist, Transplant, Laparoscopic & Robotic Surgeon, said the complex narrowing near major pelvic blood vessels made the procedure technically challenging. He added that robotic technology enabled precise dissection and suturing while supporting faster recovery.
Dr. G. Ravindra Varma, Managing Director and Senior Consultant Urologist, AINU Hospital Vizag, said the procedure helped restore ureteric continuity and preserve kidney function. He also highlighted the role of robotic technology in complex reconstructive urology.
The procedure was led by Dr. Amit Saple, along with Dr. G. Ravindra Varma and Dr. P. Sridhar, Consultant Urologist. AINU Vizag also performs other complex robotic procedures, including radical prostatectomy and radical cystectomy.