case_images: PMC10834266_01
case_images: The coronary images on preoperative computed tomography show (A) a 1.5-cm right and (B) a 2.0-cm left endophytic mass (arrows).
case_images: jyms-2023-01032f1.jpg
case_images: PMC10834266_01_jyms-2023-01032f1.jpg
case_images: f1-jyms-2023-01032
case_images: The RENAL (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score was 5 for both sides the PADUA (preoperative aspects and dimensions used for an anatomical) score was 7 for the left and 8 for the right sides (Fig. 1).
case_images: The configuration for the robotic assessment port and additional laparoscopic port is designed to (A) the bilateral access to the renal mass and (B) postoperative status 3 days after surgery at the time of discharge. Note that the drain for both sides was inserted via a single midline port for the assistant.
case_images: jyms-2023-01032f2.jpg
case_images: PMC10834266_01_jyms-2023-01032f2.jpg
case_images: f2-jyms-2023-01032
case_images: Access Kit (manufactured by Intuitive Surgical) was installed for the floating trocar technique. An additional port for the assistant manipulating the laparoscopic device was made on the midline above 5 cm from the umbilicus, with a blind supporting the peritoneum with fingers through the previously made midline incision (Fig. 2A). The operation on the right kidney was performed similarly, with the drain installed through the assist port site in the center, just like the already inserted left (Fig. 2A). The patient started a diet the next day and was discharged from the hospital on the third day according to the terms of his insurance (Fig. 2B).
case_images: (A) Preparation for the right-side procedure after undocking the robotic instrument for the left-side procedure. (B) Note that all the trocars inserted into the peritoneum were maintained utilizing surgical drape material.
case_images: jyms-2023-01032f3.jpg
case_images: PMC10834266_01_jyms-2023-01032f3.jpg
case_images: f3-jyms-2023-01032
case_images: Paul, MS, USA) was applied, maintaining all the trocars inserted into the peritoneum (Fig. 3A). The patient's position was changed to the left decubitus, and the robot was re-docked to the same port (Fig. 3B).
case_images: The coronary images on postoperative computed tomography taken 3 months after surgery demonstrate no evidence of recurrence or urine leakage (arrows).
case_images: jyms-2023-01032f4.jpg
case_images: PMC10834266_01_jyms-2023-01032f4.jpg
case_images: f4-jyms-2023-01032
case_images: There were no adverse events such as hematuria, flank pain, or readmission requiring further management for 90 days after the procedure, and no abnormalities such as surgical site recurrence, anastomotic leakage, or local inflammation were observed on the abdominal CT at 3 months (Fig. 4).