Robot-Assisted Radical Cystectomy With Orthotopic Neobladder as a Urinary Diversion for a Kidney Transplant Recipient: A Case Report

• Published in: Transplantation proceedings 2020-03, Vol.52 (2), p.608-613
• Main Authors: Ishiyama, Yudai, Yoshida, Kazuhiko, Iizuka, Junpei, Unagami, Kohei, Hashimoto, Kiyoshi, Moriyama, Ikumi, Takagi, Toshio, Kakuta, Yoichi, Okumi, Masayoshi, Kondo, Tsunenori, Ishida, Hideki, Tanabe, Kazunari
• Format: Article
• Language: English
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2019.12.002

A higher prevalence of bladder cancer is reported in solid organ recipients, and advanced cancer requires radical cystectomy combined with urinary diversion. Surgery is technically challenging in kidney transplant recipients because of urinary tract abnormalities. Here, we describe the use of a robot-assisted approach in a kidney transplant recipient. The etiology of the patient’s end-stage renal disease was bilateral hypoplastic kidney. The patient started to receive hemodialysis at 19 years of age and underwent living-related kidney transplant at 23 years of age. Thirteen years later, he was diagnosed with invasive urothelial carcinoma and underwent robot-assisted radical cystectomy with extracorporeal neobladder construction under open laparotomy. Surgery was indicated to enhance suture flexibility and dissection of the peribladder tissues. Although the patient had an intraperitoneal infection caused by leakage from the vesicourethral anastomosis site and required drainage of the abscess, his condition stabilized after antibiotic treatment. This case outlines the effectiveness of the robot-assisted approach in patients with urinary tract abnormalities, such as kidney transplant recipients. •A successful robotic cystectomy was performed in a kidney transplant recipient.•Surgery was indicated to enhance suture flexibility of peribladder tissues.•Extracorporeal neobladder construction achieved fairly favorable outcomes.•Attention should be paid to vesicourethral anastomosis and accompanying infection.