Appendiceal ureteroplasty or ureteral repair using the appendix is a procedure where a part of the ureter is replaced or expanded using the appendix. This procedure is particularly performed on the right side and is used for scar-related narrowings (strictures) of the ureter that obstruct urine flow.

In about three-quarters of the cases, this narrowing results from medical procedures or previous radiation.

Affected patients often suffer from flank pain due to urinary retention and discomfort during urination. Other possible consequences include recurring urinary tract infections, stone formation, chronic kidney failure, and, in the worst case, loss of kidney function.

This method is suitable for reconstruction on the right side, requires a functional kidney and harvesting of the appendix. Limitations may exist for patients with intestinal diseases or previous intestinal surgeries.

The Da-Vinci appendiceal ureteroplasty is a robot-assisted, minimally invasive keyhole surgery that requires special surgical expertise. Instruments are introduced under general anesthesia through small abdominal incisions and then controlled by the surgeon via a console.

During the procedure, the appendix is first isolated while preserving its blood supply (blood vessels). Then, the affected ureteral segment in the area of the stricture is replaced by the isolated appendix. Alternatively, the narrowed segment of the ureter can be slit and the longitudinally split appendix sutured onto it to expand the lumen of the ureter. Subsequently, an internal ureteral and bladder catheter are inserted for the healing phase.

The success of the operation depends on the team’s experience and specific patient data.

Every surgery carries certain risks, such as bleeding during or after the operation, damage to adjacent organs, or wound healing problems.

Previous surgeries, illnesses, or medications can affect the course of the operation and postoperative recovery. These risks are assessed individually based on the patient’s medical history.

Possible side effects include urinary retention, recurrence of scarring obstructing urine flow, urine leakage, inflammations, and urinary tract infections. Intestinal complications such as obstruction, leaks, and delayed activity, which may require further interventions, are also possible.

After the surgery, which aims at restoring normal urine flow, continuous monitoring of the kidneys is essential. Moreover, a balanced diet, adequate fluid intake, exercise, and sleep support recovery and strengthen long-term health.