Rapid re-docking technique in robot-assisted nephroureterectomy and extravesical bladder cuff excision without intraoperative repositioning: Technical feasibility and descriptive perioperative and early oncologic outcomes

Background Robot-assisted radical nephroureterectomy requires access to both the renal and pelvic operative fields. Objectives To describe the technical feasibility of a rapid re-docking technique using triangular trocar positioning for single-position robot-assisted radical nephroureterectomy (RRNU). Design Single-center retrospective observational study. Methods We retrospectively reviewed 49 patients with upper tract urothelial carcinoma and no concomitant bladder cancer who underwent surgery between February 2021 and December 2025. Of these patients, 26 underwent modified single-position RRNU and 23 underwent laparoscopic radical nephroureterectomy (LRNU). Perioperative outcomes and early oncologic events were summarized descriptively. Results Median operative time was 220.0 (IQR, 186.2–270.0) minutes in the RRNU cohort and 255.0 (IQR, 190.0–292.5) minutes in the LRNU cohort. Estimated blood loss was 100.0 (IQR, 100.0–150.0) mL and 150.0 (IQR, 125.0–200.0) mL, respectively. Mean rapid re-docking time was 7.1 ± 2.0 minutes. Median follow-up was 28.5 (IQR, 22.5–36.5) months in the RRNU cohort and 24.0 (IQR, 10.5–38.5) months in the LRNU cohort. Early oncologic events were summarized descriptively. Conclusion This rapid re-docking technique represents a feasible workflow for single-position RRNU. Larger studies with standardized follow-up are needed to evaluate long-term oncologic outcomes.