A Novel Technique of Robotic Nephroureterectomy with Bladder Cuff Excision for the Management of Upper Tract Transitional Cell Carcinoma Without Repositioning or Dedocking the Robot

Abstract

Abstract Introduction: The standard treatment for upper tract transistional cell carcinoma is radical nephro-ureterectomy with bladder cuff excision. Here we share our experience of pure robotic nephro-ureterectomy with a novel port placement allowing for single robotic docking. Methods: Port placement is integral to successful performance of the procedure without need for redocking of the robot. The patient is placed in a modified flank position at approximately 60 degrees. The port placement begins with a 12-mm camera placed 3 cm lateral to the umbilicus, off the rectus muscle. The first robotic arm port is placed lateral to the rectus muscle 7 cm cranial to the camera port. The second 8-mm port is placed 7 cm lateral to the camera. In a left-sided tumor, these two ports will serve as the left and right arm for managing the kidney, respectively. The fourth robotic 8-mm port is placed in the midline 8 cm caudal to the umbilicus. The lateral port and midline port will serve as left and right arms in manag...