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Combined robot-assisted simple prostatectomy and laparoscopic nephrectomy: a case series.

Narmina Khanmammadova1, Bruce Gao1, Johnny Wang1

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This study reports the first series of combined robotic-assisted simple prostatectomy (RASP) and robotic/laparoscopic nephrectomies in a single session. These combined procedures are safe and effective for patients with multiple urinary tract conditions and comorbidities.

Keywords:
Benign prostatic hyperplasiaCase seriesLaparoscopicNephrectomyRenal cell carcinomaRobot-assisted simple prostatectomy

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Area of Science:

  • Urology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Indications for robotic surgery in urology are expanding.
  • Combined robotic/laparoscopic surgery for synchronous upper and lower urinary tract malignancies has been previously described.
  • This is the first reported series of robotic-assisted simple prostatectomy (RASP) and robotic/laparoscopic nephrectomies in a single operative session.

Purpose of the Study:

  • To describe the feasibility and outcomes of combined robotic-assisted simple prostatectomy (RASP) and robotic/laparoscopic nephrectomies performed in a single operative session.
  • To evaluate the safety and efficacy of these combined procedures in patients with comorbidities.

Main Methods:

  • Two cases are presented: Case 1 involved a patient undergoing robotic-assisted partial nephrectomy (RAPN) and RASP sequentially.
  • Case 2 involved a patient undergoing RASP and conventional laparoscopic radical nephrectomy (LRN) in a single session.
  • Modified port placements were utilized to allow reuse of trocar sites in Case 1.

Main Results:

  • Case 1: Total operative time 221 min, estimated blood loss 100 ml, discharged POD 1. Alleviated LUTS and no cancer recurrence.
  • Case 2: Total operative time 255 min, estimated blood loss 80 ml, discharged POD 3. Ongoing oncological surveillance.
  • No transfusions were required in either case.

Conclusions:

  • Combined RAPN or LRN with RASP can be safely performed in patients with significant comorbidities.
  • Meticulous preoperative planning and a multidisciplinary care team are crucial for success.
  • Combined surgery may reduce anesthesia risks and shorten hospitalizations.