Single-position intraperitoneal laparoscopic radical nephroureterectomy using a modified supine position.

PURPOSE: To describe a novel single-position intraperitoneal laparoscopic surgery (SP-ILS) technique for radical nephroureterectomy (RNU) and bladder cuff excision (BCE) in the supine position.

METHODS

Between January 2019 and June 2023, 40 patients with UTUC underwent laparoscopic RNU and BCE using the SP-ILS technique. Clinical, perioperative, and pathological data were retrospectively analyzed.

RESULTS

All procedures were performed laparoscopically without patient repositioning. No intraoperative or postoperative complications occurred. The mean operative time was 101.0 ± 24.5 minutes, and mean estimated blood loss was 53 ± 27.0 mL. The median postoperative hospital stay was 4.2 ± 1.1 days. Postoperative pathology revealed Ta in 14 patients, T1 in 21 patients, and T2 in 5 patients. During a mean follow-up of 12.9 months (range, 2-24), one patient developed bladder recurrence.

CONCLUSIONS

The SP-ILS technique offers direct visualization, reproducible bladder cuff excision, and efficient single-position workflow during both LRNU and BCE.