Concurrent upper and lower urinary tract robotic surgery: A case series

Authors

  • Sailaja Pisipati Bristol Urological Institute, Southmead Hospital, Bristol
  • Christian Bach Bristol Urological Institute, Southmead Hospital, Bristol
  • Datesh Daneshwar Bristol Urological Institute, Southmead Hospital, Bristol
  • Edward W Rowe Bristol Urological Institute, Southmead Hospital, Bristol
  • Anthony J Koupparis Bristol Urological Institute, Southmead Hospital, Bristol

DOI:

https://doi.org/10.5489/cuaj.1836

Keywords:

Robotic Urological Surgery, Concurrent Upper and Lower Urinary Tract Surgery, Robotic Nephro-ureterectomy, Robotic Assisted Laparoscopic Prostatectomy (RALP), Robotic Assisted Radical Cystectomy (RARC).

Abstract

The da Vinci Surgical System (Intuitive Surgical Inc.) continues to develop as a platform in urological surgery. Synchronous upper and lower urinary tract tumours requiring extirpative surgery are not uncommon. We report the first case robotic series of combined complex upper and lower urinary tract surgery. Six high-risk anaesthetic patients with a median age of 71 years and apparent synchronous upper and lower urinary tract pathologies underwent concurrent robotic surgery. Five underwent robotic nephroureterectomyand robotic-assisted radical cystectomy (RARC); 1 had combined robotic nephroureterectomy and robotic-assisted radical prostatectomy (RALP). The mean length of stay was 10 days, with an average blood loss of 416.7 mL. The median console time for nephroureterectomy, RALP and RARC was 90, 90 and 210 minutes, respectively. Four patients had intra-corporeal ileal conduit urinary diversion. There were no Clavien grade 3, 4, or 5 complications. In all patients, 30- and 90-day mortality was nil. Margins were clear in the entire cohort. We concluded that combined upper and lower urinary tract robotic surgery is safe and technically feasible with acceptable complications and oncological outcomes.

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Published

2014-11-24

How to Cite

Pisipati, S., Bach, C., Daneshwar, D., Rowe, E. W., & Koupparis, A. J. (2014). Concurrent upper and lower urinary tract robotic surgery: A case series. Canadian Urological Association Journal, 8(11-12), e853–8. https://doi.org/10.5489/cuaj.1836

Issue

Vol. 8 No. 11-12 (2014): CUAJ November

Section

Case Series

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