Initial experience of robotic nephroureterectomy: a hybrid-port technique

Authors

  • Sung Yul Park,

    1. Departments of Urology, Yonsei University College of Medicine, Urological Science Institute, and Hanyang University College of Medicine, Seoul, Korea
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  • Wooju Jeong,

    1. Departments of Urology, Yonsei University College of Medicine, Urological Science Institute, and Hanyang University College of Medicine, Seoul, Korea
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  • Won Sik Ham,

    1. Departments of Urology, Yonsei University College of Medicine, Urological Science Institute, and Hanyang University College of Medicine, Seoul, Korea
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  • Won Tae Kim,

    1. Departments of Urology, Yonsei University College of Medicine, Urological Science Institute, and Hanyang University College of Medicine, Seoul, Korea
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  • Koon Ho Rha

    1. Departments of Urology, Yonsei University College of Medicine, Urological Science Institute, and Hanyang University College of Medicine, Seoul, Korea
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Koon Ho Rha, Department of Urology, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul, Korea 120-752.
e-mail: khrha@yuhs.ac

Abstract

OBJECTIVE

To report a new technique of robot-assisted laparoscopic nephroureterectomy (RANU) using a hybrid port, as RANU has recently become a minimally invasive treatment option for upper tract transitional cell carcinoma (TCC).

PATIENTS AND METHODS

Eleven consecutive patients underwent RANU by one surgeon. The first six patients were repositioned after the nephrectomy, from flank to lithotomy position, and the robot was re-docked for excision of the distal ureter and bladder cuff. The last five patients were treated by a new RANU technique that did not require a change of position or movement of the patient cart. We analysed data obtained before, during and after RANU.

RESULTS

The total operative duration was reduced by ≈50 min in last five patients. There was no improvement in hospital stay or estimated blood loss. There were no transfusions and positive surgical margins in any patient. Maintaining the patient in a flank position allows gravity to displace the bowel away from the distal ureter, not only shortening the surgery but also improving exposure of the distal ureterectomy and closure of the bladder cuff.

CONCLUSIONS

The new RANU technique is a safe and feasible treatment option for upper tract TCC.

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