Ureteral stricture are mostly iatrogenic and are a frequent complication of pelvic and abdominal surgeries or radiation therapy. Their management differ depending on the location, the size of the stricture and patients’ medical history 
The objective of this video was to present a technique of robotic ureteral reimplantation in an ileal conduit using DaVinci® FireFly™ Near Infrared Fluorescence (NIRF).

We will describe the case of a 68 years old patient who underwent radical cystectomy with ileal conduit in 2014 for a urothelial bladder carcinoma. This man underwent 5 years later an aortic prosthetic reconstruction for an abdominal aortic aneurysm. During this procedure, a left ureteral injury was made and he developed a residual unpassable iliac ureteral stricture located about 5cm from the ileal conduit and 1cm long. 
A side to side ureteral reimplantation in the ileal conduit was performed with robotic assistance.

The operating time was 330 minutes. The patient was placed in a slightly lateral Trendelenburg position allowing to keep an access to the nephrostomy tube in order to be able to perform simultaneous ureteroscopy. The procedure begins by an important adhesiolysis. The left ureter is identified with the help of antegrade ureteroscopy. The injection of indocyanine green in the ileal conduit using the FireFly™ Fluorescence mode helped for the identification of the conduit. The healthy ureter up to the stricture was also identified by NIRF after intravenous injection of indocyanine green. 
A side to side uretero-ileal anastomosis was performed tensionless and without ureteral transection in order to preserve its blood supply.  
A double J stent and a nephrostomy were placed at the end of the procedure. 
The post-operative evolution has been marked by an intestinal fistula that required reoperation to close the fistula and a temporary ileostomy (Clavien 4). After 3 months, an antegrade opacification has been performed and showed a full patency of the uretero-ileal anastomosis and the ileostomy has been closed. After 6 months, the patient has remained stent-free.

Robotic assistance for reconstructive surgery such as ureteral reimplantation in an ileal conduit seems very interesting because it provides helpful innovative technologies such as the FireFly™ NIRF which can help the surgeon to identify structures and visualize their proper vascularization. Side to side retrosigmoid ureteral reimplantation in the ileal conduit seems to be a good option for mid ureter stricture in patients with ileal conduit.