Bladder removal due to cancer can lead to the subsequent development of strictures in the ureters in up to 19% of cases. This complication consists in the narrowing of the tubes through which urine flows from the kidneys to the bladder. This means that patients have to be reoperated again, with a high risk of other complications, since it is usually an aggressive surgery that requires the opening of the abdomen. To repair these strictures in a minimally invasive way, the team of the Bladder Cancer section of the Vall d'Hebron University Hospital composed of Dr. Albert Carrión, Dr. Carles Raventós and Dr. Fernando Lozano has proven the effectiveness and safety of a new technique using robotic surgery. Dr. Albert Carrión, assistant physician of the Urology Service of the Vall d'Hebron University Hospital and researcher of the Biomedical Research in Urology group of the Vall d'Hebron Research Institute (VHIR), has led the work published in the journal European Urology Open Science, which has received the award for the best publication in urology granted by the UB-HUB Chair on ABEX Robotic Surgery, attached to the Bellvitge Campus of the Faculty of Medicine and Health Sciences of the University of Barcelona.

In the study, 63 ureteral stricture repair surgeries were performed on 61 patients in seven hospitals in Europe and the United States. In all cases, the operations were performed assisted by the Da Vinci surgical robot, and in no case were complications detected during the procedure. "This is a much less invasive and more precise method than the usual surgeries, which can be of great benefit to patients", explains Dr. Carrión.

The authors of the study also analyzed the possible complications that appeared after surgery. Twenty-three patients (37%) suffered complications, but most were considered mild, such as urinary tract infections. Only three cases (5%) were serious and, therefore, the authors believe that this technique would reduce the risks compared to classic open surgery.

On the other hand, it is noteworthy that 19 months after the intervention, 84% of the patients had not developed new strictures of the ureters, a fact that shows the success of the surgical technique. Among the factors that can be related to the evolution of the patients, the results show that those who had previously required abdominal or pelvic radiotherapy had a higher risk of developing new strictures in the future.

"In this multicenter study, we have proven that it is feasible to perform this type of complex robotic surgery with good results. It is necessary to continue research with a larger number of patients to prove the efficacy and safety of this technique", says Dr. Carrión.

UB-HUB Chair on ABEX Robotic Surgery Awards

The UB-HUB Chair on ABEX Robotic Surgery, attached to the Bellvitge Campus of the Faculty of Medicine and Health Sciences of the University of Barcelona, has awarded its first prizes for research on robotic surgery. The awards have been granted to papers published during 2020 and 2021 in national and international journals in the fields of urology, general and digestive system surgery, thoracic surgery, gynecology and obstetrics and otorhinolaryngology. Its aim has been to recognize the efforts of surgical teams in learning and research in this field, as well as to establish and consolidate links with other hospital centers.