Simultaneous Robot-Assisted Radical Prostatectomy and Robot-Assisted Partial Nephrectomy for Synchronous Prostate Cancer and Small Renal Tumors: A Single-Center Experience and Literature Review of Concurrent Robotic Multisite Surgery

Introduction: This review explores the literature and presents institutional cases of concurrent robotic multisite surgery—in particular, robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN) for synchronous prostate and kidney cancers. We highlight dual-console synchronous robotic procedures, emphasizing the unique docking tech-nique developed. Aim: The aims of the study were to evaluate the feasibility, safety, and clinical outcomes of concurrent RARP and RAPN for synchronous prostate cancer and small renal tumors, as well as other concurrent robotic multisite surgeries, and to compare institutional findings with the existing literature. Materials and Methods: We describe the unique docking technique used in our procedures, which facilitates atraumatic transitions between surgeries using the same port sites. Additionally, eligible studies on concurrent robotic multisite surgery that were published in English were retrieved from the MEDLINE, Embase, and Cochrane Library databases. Data on operative time, blood loss, complications, and postoperative outcomes were extracted. Results: Eight cases from our institution demonstrated the feasibility and safety of the proposed approach, which is consistent with previous reports. The unique docking technique and dual-console setup enhance surgical precision, offering significant benefits in patient outcomes. As part of the litera-ture review, nine retrospective studies involving 40 cases of concurrent RARP and RAPN were reviewed. Additionally, eleven retrospective studies involving 392 cases of concomitant RARP and robotic transabdominal preperitoneal inguinal hernia repair (RTAPPIHR) were analyzed. Conclusions: Concurrent RARP and RAPN for synchronous prostate and kidney tumors is a viable and effective approach. Our early experience suggests that this and other combined procedures can optimize patient care and reduce costs. Prospective trials are needed to validate these findings and further refine the techniques.