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Chinese Journal of Laparoscopic Surgery(Electronic Edition) ›› 2026, Vol. 19 ›› Issue (04): 220-224. doi: 10.3877/cma.j.issn.1674-6899.2026.04.005

• Specialist Forum • Previous Articles    

Multidisciplinary robotic surgery for ureteral endometriosis

Lei Zhang1, Yingfang Zhou1, Lihui Zhang1, Xiaoqing Wang1, Yu Wang1, Mengran Liu1, Pan Song2, Hang Fan2, Kunlin Yang2, Caiyong Lai2, Chao Peng1, Yan Huang1, Xuesong Li2, Ye Lu1,†()   

  1. 1Department of Obstetrics and Gynecology and Reproductive Center, Peking University First Hospital, 100034, China
    2Department of Urology, Peking University First Hospital, Peking University Institute of Urology, National Research Center for Genitourinary Oncology, 100034, China
  • Received:2026-06-16 Online:2026-08-30 Published:2026-10-09
  • Contact: Ye Lu

Abstract:

Ureteral endometriosis (UE) is one of the common types of deep infiltrating endometriosis (DE), easily causing upper urinary tract obstruction and being an important cause of "silent kidney loss" in women of reproductive age. At Peking University First Hospital, robot-assisted laparoscopic surgery for UE has been performed under the multidisciplinary team (MDT) model, with a high surgical success rate and a low recurrence rate. Our experience and characteristics mainly include five aspects: (1) re-recognition of prevalence: the actual prevalence of UE may be severely underestimated; given the limited detection ability of imaging, UE is often identified incidentally during intraoperative ureteral dissection in patients with DE; (2) shift of surgical philosophy: for patients with severe stenosis, especially those with concurrent DE undergoing conservative fertility-preserving surgery, ureteroneocystostomy with an anti-reflux mechanism has a lower recurrence rate than ureteroureterostomy or ureterolysis with lesion excision, fitting the philosophy of "one surgery in a lifetime" ; (3) innovation of collaboration model: routine preoperative multidisciplinary evaluation and the "dual-specialty same-table" surgical model of gynecology and urology are superior to intraoperative ad hoc consultation; (4) remote surgery and platform workflow: remote dual-specialty same-table surgery across hospitals based on the domestic "4+ 1" robotic platform, together with a unified postoperative follow-up pathway; (5) extension of fertility management: preoperative fertility assessment and preservation, multidisciplinary monitoring during pregnancy, and long-term postpartum management constitute full-life-cycle care.

Key words: Endometriosis, Ureter, Robotic surgery, Multidisciplinary team, Ureteroneocystostomy

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