Tissue Substitution in Reconstruction

As robotic surgical techniques have evolved to include urologic reconstruction, the difficulty of cases amenable to minimally invasive techniques has increased. Some of these more complicated repairs involve compromised local tissue. Therefore, it is critical for the robotic urologic reconstructionist to have a familiarity with the wide arsenal of flaps and grafts available for use to augment various closures or anastomoses. When considering a graft or flap, one must weigh the health of the local tissues, nature of the surgery, and the risks and benefits given the morbidity associated with the donor site. With numerous options for tissue substitution available, we describe some of the more commonly used tissues during urologic reconstruction with salient information regarding indications, technique, and outcomes.