Flexible Ureterorenoscopy and Robotic Surgery

Erdal Alkan, MD, Oguz Ozkanli, MD, Mevlana Derya Balbay, MD

Department of Urology, Memorial Sisli Hospital, Okmeydanı, Sis¸li-; Istanbul, Turkey (Drs. Alkan, Balbay). Department of Anesthesiology, Memorial Sisli Hospital, Okmeydanı, Sisli-; Istanbul, Turkey (Dr. Ozkanli).


Introduction: We present the feasibility of flexible ureteroscopic lithotripsy concomitant with robot-assisted radical prostatectomy and bilaterally extended pelvic lymphadenectomy.

Methods: Two patients underwent flexible ureteroscopic lithotripsy, robot-assisted radical prostatectomy, and pelvic lymphadenectomy at one anesthesia session. Flexible ureteroscopic lithotripsy was performed first. Later, robotic prostatectomy and lymphadenectomy were performed with the patient in the exaggerated 30° Trendelenburg position. All relevant preoperative clinical details, intraoperative details, problems encountered, complications, hospital stay, postoperative recovery, pathologic findings, and clinical follow-up were assessed.

Results: Both patients were discharged uneventfully from the hospital on the third postoperative day. In the postoperative first month, the double-J stents were removed. Both patients were prescribed hormonal treatment and were also referred for radiotherapy due to final pathology and postoperative prostate-specific antigen levels.

Conclusion: Combining robot-assisted radical prostatectomy and flexible ureteroscopy is feasible in patients with urinary stone disease and prostate cancer concomitantly.

Key Words: Flexible ureterorenoscopy, Urolithiasis, Robotic surgery, Prostate cancer, One anesthesia session.

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