Single-Port RAS Using Da Vinci SP Surgical System for UTUC Patients

To evaluate safety, surgical outcomes, patient characteristics, and patient-reported outcomes of radical nephroureterectomy using single-port robotic surgery

Inclusion criteria

• Age 20 years or more
• Histologically or cytologically diagnosed upper tract urothelial cancer
• Fitting indications of radical nephroureterectomy and ipsilateral bladder cuff resection, and deemed feasible for robotic surgery
• ASA physical status classification 1-2 and adequate organ function
• Patients willing and able to comply with study protocol requirements and follow-up
• With informed consent

Exclusion criteria

• Synchronous bladder cancer
• Distant metastasis of cancer
• BMI ≥30 or BMI <18.5
• Unable to tolerate lateral decubitus or Trendelenburg position (relative contra-indication)
• Severe adhesion due to prior abdominopelvic surgery (relative contra-indication)
• Previous radiation treatment to the pelvic area
• Active infectious disease
• Severe concomitant illness that drastically shortens life expectancy or increases risk of therapeutic interventions, such as: severe heart disease (NYHA functional class III-IV) or severe lung disease (GOLD Group C-D)
• Cannot follow trial-required procedures
• Concomitant systemic or pelvic disease that increases the risk of surgery
• Long-term use of anti-coagulant(s)
• Patients with coagulopathy
• Emergency surgery