Initial experience of robotic nephroureterectomy: a hybrid-port technique
Article first published online: 10 JUN 2009
© 2009 THE AUTHORS. JOURNAL COMPILATION © 2009 BJU INTERNATIONAL
Volume 104, Issue 11, pages 1718–1721, December 2009
How to Cite
Park, S. Y., Jeong, W., Ham, W. S., Kim, W. T. and Rha, K. H. (2009), Initial experience of robotic nephroureterectomy: a hybrid-port technique. BJU International, 104: 1718–1721. doi: 10.1111/j.1464-410X.2009.08671.x
- Issue published online: 10 NOV 2009
- Article first published online: 10 JUN 2009
- Accepted for publication 30 March 2009
- ureteric neoplasms
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.
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.
The new RANU technique is a safe and feasible treatment option for upper tract TCC.