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

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.