Single port robot assisted nephroureterectomy

Abstract

Objective: This video aims to demonstrate the feasibility of performing a nephroureterectomy using the novel da Vinci Single Port (SP) robotic platform and to provide a step-by-step guide to the technique utilized at our institution. Patients and surgical procedure: A 61-year-old man with a history of left nephrolithiasis presented with a left ureteral stent that had been retained for five years, which had subsequently developed an encrusted staghorn calculus and bladder stone around the stent. Further imaging confirmed that the left kidney was nonfunctioning. The patient underwent a left SP nephroureterectomy with removal of the retained stent and bladder stone. During surgery, the ureter appeared significantly enlarged and fibrotic. The rest of the case proceeded without complication, with successful removal of the kidney, stent, and bladder stone via a small cystotomy, which was closed with a running 3–0 V-loc suture. We were able to access both the kidney and the bladder via a single incision without relocating the robot or creating a separate incision. Results: The patient had an uneventful recovery and was discharged home the day after surgery. Conclusion: SP robotic-assisted laparoscopic nephroureterectomy is a feasible approach that takes advantage of the unique advantages of the SP system, such as the ability to reach all four abdominal quadrants through a single incision without moving the main body of the robot.