Background/Objectives: Simultaneous robotic-assisted radical cystectomy (RARC) and nephroureterectomy (RARNU) offers a minimally invasive alternative to open approach for patients with synchronous bladder and upper urinary tract cancers, as well as in selected benign conditions. This study presents our single-center experience and also includes a review of the relevant literature. Methods: All patients undergoing combined RARC and RARNU between 2016 and 2023 were retrospectively identified. Clinical and demographic data—including preoperative pathology, operative and re-docking times, estimated blood loss, complications (Clavien–Dindo system), surgical margins, recurrence, morbidity, and follow-up—were collected. A rapid review of the literature was also conducted. Results: From 2016 to 2023, 10 patients (mean age 67.4 years, range 56–77) underwent combined RARC and RARNU for upper/lower tract urothelial malignancy. Mean re-docking time was 68.2 min (range 51–100), mean operative time 524.5 min (range 380–690), and mean blood loss 427 cc (range 75–1170). A Pfannenstiel incision was used for en bloc specimen extraction, with no complications or incisional hernias. One case was converted to open surgery, and two required extracorporeal diversion. Postoperatively, five Grade 2 complications were reported, along with one Grade 3, and one Grade 5. All surgical margins were negative. Mean hospital stay was 11.5 days (range 5–29). At a mean follow-up of 21.7 months, one patient had become dialysis-dependent and one had experienced recurrence requiring further surgery. The review of the literature included 74 patients with comparable outcomes. Conclusions: Combined RARC and RARNU is a feasible, minimally invasive option for selected patients. Although technically demanding, it offers acceptable safety and should be performed in high-volume, specialized centers.
Kostakopoulos et al. (Wed,) studied this question.