Abstract
INTRODUCTION AND OBJECTIVES: Urethrectomy with appendicovesicostomy is a treatment option for low stage urethral cancer. We present a novel minimally-invasive surgical approach which allows for robotic appendicovesicostomy to be performed simultaneously with open urethrectomy. METHODS: A 71 year-old man presented with clinically-localized squamous cell carcinoma of the urethra. He underwent a traditional open urethrectomy with simultaneous robotic-assisted bladder neck closure, omental J flap interposition, and appendicovesicostomy. The robot was side-docked to allow for a perineal surgeon to work in tandem with the robotic surgeon. RESULTS: Total operating room time was 391 minutes. Robotic console time was 281 minutes. Length of stay was four days. There were no complications, and no secondary procedures were required. Final pathology demonstrated T2 squamous cell carcinoma with negative margins. At 6 months follow up, the patient is continent and cancer-free. CONCLUSIONS: Simultaneous extirpative surgery and minimally-invasive urinary tract reconstruction is possible for patients with urethral cancer. Side-docking the robot allows for two surgical teams to work concurrently. This approach may be applicable to other procedures requiring both open perineal and laparoscopic intraabdominal access.
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