Robot-Assisted Radical Nephroureterectomy
Radical nephroureterectomy with formal bladder cuff excision was first proposed in 1933 for the treatment of papillomatous tumors of the renal pelvis and ureter. This approach has become standard of care for upper urinary tract neoplasms as many of these tumors are characterized by multifocality, high ipsilateral recurrence rates after partial resection, and low (<5%) incidence of contralateral disease. A laparoscopic approach to nephroureterectomy was first described in 1991. A laparoscopic approach to upper tract neoplasm has become more prevalent with increasing evidence supporting equivalent oncologic outcomes and a faster convalescence as compared to open surgery. More recently, robot-assisted radical nephroureterectomy has been described as an alternative to laparoscopic nephroureterectomy due to the potential for improved surgeon efficiency in suturing, ergonomics, and ease of bladder reconstruction after bladder cuff excision without compromising oncologic efficacy. In this chapter we describe the technique of robot-assisted laparoscopic nephroureterectomy.
KeywordsRadical nephroureterectomy Robot-assisted surgery
Procedures of robot-assisted radical nephroureterectomy (WMV 75743 kb)
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