Ureteral reimplantation is one of the most challenging areas in urology, particularly in cases involving recurrent stone disease, extensive fibrosis from multiple prior surgeries, or iatrogenic trauma. Conventional management in such "hostile" surgical fields often carries high morbidity or low success rates with endoscopic approaches. The robotic platform, with its 3D high-definition visualization and superior maneuverability in confined spaces, allows for meticulous tissue dissection and tension-free ureteroneocystostomy. This video demonstrates our surgical techniques and clinical outcomes in four complex ureteral cases with diverse etiologies.

We analyzed four cases with distinct pathologies managed via robotic-assisted ureteral reimplantation at a tertiary center:
•	Case 1: A male patient with a history of 6 prior operations for right renal stones, currently managed with a percutaneous nephrostomy. 
•	Case 2: A male patient with an impacted stone at the right ureterovesical junction (UVJ) following 3 failed endoscopic interventions. 
•	Case 3: A 53-year-old female with primary left UVJ stricture, presenting with 13.5 mm ureteral wall thickening and Grade 3 hydronephrosis (HUN). 
•	Case 4: A female patient with ureteral injury and urinary extravasation following Total Abdominal Hysterectomy (TAH), managed with annual stent replacements for 1.5 years. 
The video highlights critical surgical steps: port placement, identification and mobilization of the ureter within dense scar tissue, resection of the stenotic segment, and robotic ureteroneocystostomy techniques.

All procedures were successfully completed robotically without conversion to open surgery. Operative times ranged from 120 to 180 minutes. In Case 4, preoperative urine culture identified Candida albicans (10,000 cfu/mL), necessitating perioperative targeted antifungal management. Postoperatively, a cystogram in Case 3 confirmed the absence of extravasation, leading to successful catheter removal. All patients showed significant regression in hydronephrosis (e.g., Case 3 improved from Grade 3 to Grade 1). No Clavien-Dindo Grade III–V complications were observed during the follow-up period.

Robotic-assisted ureteral reimplantation serves as a reliable salvage and primary treatment modality for complex ureteral strictures resulting from multiple prior stone surgeries or iatrogenic gynecological injuries. Meticulous robotic dissection and management of preoperative infections, such as fungal colonization, are fundamental to achieving successful reconstructive outcomes. This series demonstrates that the robotic platform effectively handles high-difficulty cases with minimal morbidity and excellent functional recovery.