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A 38-year-old patient underwent the technique with an operative time of about 220 minutes and minimal blood loss. Follow-up imaging showed persistent hydronephrosis reduction, confirmed patency after Double-J stent removal, and no reported postoperative symptoms.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/robotic-tubular-pyeloureteroplasty-using-flap-and-lingual-mucosal-graft-a-case-report-and-literature-review/456691/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/robotic-tubular-pyeloureteroplasty-using-flap-and-lingual-mucosal-graft-a-case-report-and-literature-review/456691.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What surgical problem does the paper address?","Question",{"text":112,"@type":113},"It addresses recurrent ureteropelvic junction obstruction (UPJO) associated with long proximal ureteral obliteration, where conventional pyeloplasty is difficult due to high tension and scarring.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the robotic tubular pyeloureteroplasty constructed in the case?",{"text":117,"@type":113},"The posterior plate of the anastomosis was formed using a renal pelvis flap, while the anterior plate used a lingual mucosal graft (LMG), creating a wide, tubularized, well-vascularized UPJ.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes were reported after surgery?",{"text":121,"@type":113},"Follow-up ultrasound and computed tomography urography showed sustained hydronephrosis reduction, antegrade urography confirmed no obstruction after Double-J stent removal, and no complications or symptoms were observed during follow-up.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},456691,1791286279,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","Robotic tubular pyeloureteroplasty using flap and lingual mucosal graft: a case report and literature review  \nKangxiang Xu 1,2,3\\# ^, Chaoqi Liang 1,2,3\\# , Yuancheng Zhou 1,2,3\\# , Shuaishuai Chai 1,2,3 , Jianjun Fang 1 , Xingyuan Xiao1,2,3, Bing Li1,2,3^  \n1Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China; 2Institute of Urology, Wuhan University, Wuhan, China; 3Hubei Key Laboratory of Urological Diseases, Wuhan, China  \n\\#These authors contributed equally to this work.  \nCorrespondence to: Bing Li, MD; Xingyuan Xiao, MD. Department of Urology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430071, China; Institute of Urology, Wuhan University, Wuhan, China; Hubei Key Laboratory of Urological Diseases, Wuhan, China. [Email: bingli2023@whu.edu.cn](Email: bingli2023@whu.edu.cn); [xiaoxingyuan@whu.edu.cn](xiaoxingyuan@whu.edu.cn).  \nBackground: Recurrent ureteropelvic junction obstruction (UPJO) accompanied by long proximal ureteral obliteration presents significant challenges for conventional pyeloplasty, primarily due to the elevated tension at the surgical site. Additionally, previous surgeries often lead to scar tissue formation, complicating both the  \nidentification of healthy tissue and the success of reconstruction.  \nCase Description: A 38-year-old patient with right UPJO successfully underwent robotic tubular pyeloureteroplasty using a flap and lingual mucosal graft (LMG) . The surgical technique involved using the flap to form the posterior plate of the anastomosis, with the LMG serving as the anterior plate, resulting in a wide, tubularized, and well-vascularized ureteropelvic junction. Intraoperative blood loss was about  \n50 mL, and operative time was about 220 minutes. Follow-up ultrasound demonstrated sustained reduction in hydronephrosis, which was further confirmed by improved findings on computed tomography urography. Antegrade urography confirmed the absence of ureteral obstruction following removal of the Double-J stent, with no complications observed. During follow-up assessments, the patient reported no symptoms after surgery. By sixteen months postoperatively, the glomerular filtration rate of the right renal increased from  \n25.03 to 28.03 mL/min, and split renal function improved from 33.00% to 37.56% .  \nConclusions: Robotic tubular pyeloureteroplasty using a flap and LMG is a safe and effective surgical option, offering a promising treatment for selected patients with UPJO. This technique serves as an  \nalternative for those with complex anatomical challenges typically encountered in pyeloplasty.  \nKeywords: Renal pelvis flap; lingual mucosal graft (LMG); pyeloureteroplasty; ureteropelvic junction obstruction  \n(UPJO); case report  \nSubmitted Aug 31, 2025. Accepted for publication Oct 29, 2025. Published online Dec 18, 2025.  \ndoi: 10.21037/tau-2025-646  \nView this article at: [https://dx.doi.org/10.21037/tau-2025-646](https://dx.doi.org/10.21037/tau-2025-646)  \nIntroduction  \nUreteropelvic junction obstruction (UPJO) is a prevalent urological condition that can arise from various factors, including vascular compression or the formation of calculi (1) . The Anderson-Hynes pyeloplasty remains  \nthe standard surgical approach for UPJO, demonstrating a high success rate exceeding 90% in adult patients (2) . However, initial surgical intervention for UPJO may lead to recurrent obstruction due to factors such as scar tissue formation and fibrosis, crossing vessels, or technical failures  \n^ ORCID: Kangxiang Xu, 0000-0002-3751-0595; Bing Li, 0000-0002-7041-6701.  \n© AME Publishing Company. Transl Androl Urol 2025;14(12):4048-4055 | [https://dx.doi.org/10.21037/tau-2025-646](https://dx.doi.org/10.21037/tau-2025-646)  \nTranslational Andrology and Urology, Vol 14, No 12 December 2025 4049  \n(3-5) . Pyeloplasty is generally indicated for patients with localized UPJO, preserved renal function, and no significant anatomical distortion (6) . Recurrent UPJO complicated by l","cbCaiaB4skT8EH5p","https://ap.wps.com/l/cbCaiaB4skT8EH5p","pdf",1433701,"English","# Background\n# Case Description\n# Conclusions\n# Introduction\n# Highlight Box","[{\"question\":\"What surgical problem does the paper address?\",\"answer\":\"It addresses recurrent ureteropelvic junction obstruction (UPJO) associated with long proximal ureteral obliteration, where conventional pyeloplasty is difficult due to high tension and scarring.\"},{\"question\":\"How was the robotic tubular pyeloureteroplasty constructed in the case?\",\"answer\":\"The posterior plate of the anastomosis was formed using a renal pelvis flap, while the anterior plate used a lingual mucosal graft (LMG), creating a wide, tubularized, well-vascularized UPJ.\"},{\"question\":\"What outcomes were reported after surgery?\",\"answer\":\"Follow-up ultrasound and computed tomography urography showed sustained hydronephrosis reduction, antegrade urography confirmed no obstruction after Double-J stent removal, and no complications or symptoms were observed during follow-up.\"}]","Robotic Tubular Pyeloureteroplasty Using Flap and Lingual Mucosal Graft - A Case Report and Literature Review | PDF",1790746730]