Single-Position Robot-Assisted Laparoscopic Nephroureterectomy for Duplicated Kidneys and Ureters: Technique and Outcomes

Purpose Robot-assisted laparoscopic nephroureterectomy has reached a high level of maturity. However, operating on patients with duplex kidneys presents added challenges, primarily due to the large-scale resection and the need for re-positioning. This study aims to elaborate on the technique and outcomes of single-position robot-assisted nephroureterectomy for duplicated kidneys and ureters. Methods In our department, 23 patients diagnosed with duplicated renal collecting systems were selected. 10 patients underwent single-position robot-assisted laparoscopic nephroureterectomy (single-position group), and 13 had traditional robot-assisted laparoscopic nephroureterectomy (non-single-position group). We systematically collected their demographic data, surgical indications, and perioperative variables, and meticulously evaluated the surgical outcomes. Results All 23 patients underwent successful surgeries without conversion to open procedures. No remarkable differences were detected in the baseline clinical characteristics. The single-position group had a shorter operation time (166.20 ± 21.29 min vs. 208.31 ± 23.30 min, p < 0.001) and drainage tube indwelling time (3.50 ± 0.53 days vs. 4.15 ± 0.69 days, p < 0.05). Additionally, a statistically significant disparity in estimated blood loss (EBL) was noted between the two groups (136.00 ± 18.14 ml vs. 165.77 ± 40.72 ml, p < 0.05). There were no differences in post-operative hospital stays and pre-and post-operative estimated glomerular filtration rate (eGFR), and no recurrence was observed. Conclusion Single-position robot-assisted nephroureterectomy is both a reliable and secure surgical treatment for duplicated renal collecting systems, offering benefits such as reduced operative time, minimal minor complications, less estimated b l ood loss, and a high rate of surgical success.