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Robotic-assisted nephroureterectomy and bladder cuff excision without intraoperative repositioning
Ashok K Hemal1, Irina Stansel, Paurush Babbar
1Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. ahemal@wfubmc.edu
Urology
|June 18, 2011
Summary
This study presents a novel robotic nephroureterectomy with bladder cuff excision (RNUBCE) technique. The described surgical approach for upper tract transitional cell carcinoma is safe and effective, with no short-term recurrences observed.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Upper tract transitional cell carcinoma (UTTCC) requires nephroureterectomy with bladder cuff excision.
- Minimizing operative complications and ensuring oncological control are paramount in UTTCC management.
Purpose of the Study:
- To detail a novel robotic nephroureterectomy with bladder cuff excision (RNUBCE) technique.
- To present surgical tips for successful RNUBCE without patient repositioning or robot redocking.
Main Methods:
- Fifteen patients with UTTCC underwent RNUBCE between January 2009 and May 2010.
- Strategic port placement, ureter clipping before renal hilum ligation, and specific bladder stay sutures were employed.
- Lymphadenectomy was performed based on clinical indications.
Main Results:
- All RNUBCE procedures were successfully completed without complications.
- Mean operative time was 184 minutes, with an average blood loss of 103 mL.
- Mean hospital stay was 2.7 days, and short-term oncological follow-up showed no recurrences.
Conclusions:
- Robotic nephroureterectomy with bladder cuff excision (RNUBCE) is a viable treatment for UTTCC.
- The described technique, including lymphadenectomy when indicated, offers a safe and effective surgical option.
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