Simultaneous robot assisted laparoscopic radical nephroureterectomy; genital tract and paravaginal nerve sparing radical cystectomy; superextended lymph node dissection and intracorporeal Studer pouch reconstruction for bladder cancer: Robotic hat-trick.

The case of a simultaneous robotic radical nephroureterectomy, genital tract and paravaginal nerve-sparing robotic radical cystectomy, super-extended pelvic lymph node dissection and intracorporeal Studer pouch construction on a 57-year old female patient with muscle invasive bladder and distal ureteral tumors, along with a hydroureteronephrotic nonfunctioning right kidney is presented. The entire surgery was completed through a total of 8 ports in 9.5 hours. The patient was discharged home on postoperative day-6 and a JJ-stent attached to the urinary catheter was removed altogether on postoperative day-21. This complex surgery can be done safely robotically with excellent oncological outcomes and no surgical and wound complications in the short term.