Application of omental covering technique in robot-assisted lingual mucosa graft ureteroplasty

Abstract

Background: Omentum has a wide application value in ureteroplasty, however, some specific situations limit its clinical application. Therefore, we modified the application method of omentum and proposed a new method named omental covering (OC) technique. This study aims to systematically evaluate the safety and efficacy of OC technique in robot-assisted lingual mucosa graft ureteroplasty (RA-LMGU). Methods: We conducted a retrospective analysis of data from 79 patients who underwent RA-LMGU between June 2021 and October 2024 at two hospitals. Patients were divided into two groups according to the method of omental application: the omental wrapping (OW) group and the OC group. Perioperative and follow-up data were collected. Results: A total of 79 patients were included, with 24 in the OW group and 55 in the OC group. The median ureteral stricture length was 4.3 [interquartile range (IQR), 3.7, 6.0] cm in the OW group and 3.0 (IQR, 2.1, 4.0) cm in the OC group (P<0.001). The median operative time was 181 (IQR, 139, 217) min in the OW group and 150 (IQR, 110, 198) min in the OC group (P=0.06). The median postoperative stay was 7 (IQR, 7, 8) days in the OW group and 6 (IQR, 5, 7) days in the OC group (P<0.001). The median follow-up time was 32 (IQR, 26, 39) months in the OW group and 11 (IQR, 4, 16) months in the OC group (P<0.001). It is worth noting that both groups achieved a 100% surgical success rate. Conclusions: These short-term follow-up results demonstrated that the OC technique is also safe and effective in ureteral repair and reconstruction using lingual mucosa graft and it can reduce postoperative stay.