Concomitant Robot-Assisted Partial Nephrectomy and Pyelolithotomy for Small Renal Cell Carcinoma and Partial Staghorn...

Management of a small renal mass and a renal stone in the same kidney presents several dilemmas. Simultaneous robot-assisted partial nephrectomy and pyelolithotomy via the same surgical access site is a reasonable approach in a patient with both entities. An 80-year-old woman was diagnosed with a 2.3-cm enhancing mass in the lower pole of the right kidney (cT1aN0M0, RENAL score 4a) and a 1.5-cm ipsilateral partial staghorn calculus. Concurrent robot-assisted partial nephrectomy and pyelolithotomy was planned. Partial nephrectomy was performed first, followed by pyelolithotomy performed through the same surgical access. Both operations were completed successfully. The total operation time was 319 min and the estimated blood loss was 30 mL. Warm ischemia time was 22 min. There were no intraoperative or postoperative complications. Simultaneous robot-assisted partial nephrectomy and pyelolithotomy was technically feasible and safe. This minimally invasive approach should be considered when managing a kidney that contains both entities.