Comparison of Single-docking Robotic-assisted and Traditional Laparoscopy for Retroperitoneal Lymph Node Dissection during Nephroureterectomy with Bladder Cuff Excision for Upper-tract Urothelial Carcinoma

Objective To compare the results of traditional laparoscopy and a simple, single-docking robotic approach for retroperitoneal lymph node dissection (RPLND), nephroureterectomy, and bladder cuff excision. Materials and Methods We evaluated 63 and 37 consecutive patients who underwent laparoscopic and robotic nephrouretectomy with RPLND, respectively, for upper-tract urothelial carcinoma (UTUC). Results Our robotic approach was associated with improved lymph node procurement (21.0 nodes [interquartile range 16.0-30.0]) when compared with laparoscopy (11.0 nodes [interquartile range 5.5-21.0]) (P <.0001). Major blood loss as defined by requiring a blood transfusion was less for the robotic group than for the laparoscopic cohort (8% vs 30%) (P =.012). In contrast, the robotic group had longer operative times (5.1 vs 3.9 hours) (P =.0001) and longer hospital stays (5.0 vs 4.0 days) (P =.0002). Conclusion Our single-docking robotic technique for concomitant RPLND during nephrouretectomy is associated with improved lymph node yield.