For a study, researchers sought to explain a brand-new single-port, endorobotic procedure for collecting rectal mucosa grafts (RMGs) for urethral repair.

Recurrent obstructive voiding symptoms were experienced by a 57-year-old man who had undergone transurethral operations before. A panurethral stricture from the bulbomembranous junction to the meatus was seen on urethrography. Surgery was chosen as the best course of action. Due to the length of the stricture, oral mucosa that was already present would need to be supplemented; hence, a single rectal mucosa transplant was suggested for healing. Transanal harvesting was made possible via a single-port (SP) endorobotic method. An anal canal was used to introduce a GELPOINT Path transanal access platform while the patient was in a modified lithotomy posture. An AirSeal CO2 insufflator was used to establish pneumorectum at 12 mmHg. There was a docked Da Vinci SP surgical system with a monopolar spatula and Maryland bipolar forceps. Endorobotic submucosal dissection started posteriorly proximal to the dentate line after ORISE gel injection.

Using the proper hemostasis, a 21×3 cm strip of mucosa was acquired by moving cranially through the rectal submucosa. The graft that resulted was greatly thinned. The patient was moved to high lithotomy once the robot was undocked. The patient received a dorsolateral approach, penis-inverting augmentation urethroplasty. The patient was released from the hospital with an indwelling catheter on the second postoperative day without any issues.

To offer replacement grafts for long-segment urethral repair, transanal rectal mucosal dissection with a single-port endorobotic method may be an alluring and least invasive harvesting technique.

Reference: goldjournal.net/article/S0090-4295(22)00340-5/fulltext