Robotic Right Ureteroureterostomy for a Right Retrocaval Ureter

Retrocaval ureter is a rare congenital anomaly caused by aberrant inferior vena cava development, resulting in posterior deviation and extrinsic compression of the right ureter that may lead to hydronephrosis and flank pain in adulthood. This video documents a robotic right ureteroureterostomy performed for a right retrocaval ureter in a 43-year-old gentleman with chronic intermittent right flank pain and imaging-confirmed hydroureteronephrosis. The patient underwent elective minimally invasive reconstruction with careful mobilization of the ureter from behind the inferior vena cava and tension-free ureteroureterostomy with internal stenting. The procedure was well tolerated, and postoperative imaging demonstrated improving hydronephrosis without obstruction. At two-year follow-up, the patient remained asymptomatic with preserved renal function. This case highlights the role of robotic ureteroureterostomy as a safe and durable treatment option for symptomatic retrocaval ureter.