Robotic nephroureterectomy

Upper tract urothelial cell carcinoma (UT-UCC) can be an aggressive cancer and warrants extirpative treatment for most patients. Although nephron-sparing options exist, the standard treatment for UT-UCC remains nephroureterectomy (NU) with bladder cuff excision. Traditionally, NU and bladder cuff excision have been performed in an open fashion via a single large incision or two separate incisions. While conventional laparoscopic techniques have gained popularity, its widespread acceptance was hindered by the challenges of removing the distal ureter and bladder cuff with subsequent bladder repair. With the advent of robot-assisted laparoscopic surgery, this problem has been mostly overcome. Robot-assisted laparoscopic nephroureterectomy allows for replication of the open procedure with decreased morbidity and equivalent cancer control and is described in this chapter.