First full intracorporeal robotic cystectomy and neobladder in a renal transplant recipient.

The literature regarding robotic-assisted radical cystectomy in kidney transplant recipients is limited. We present the first reported case of robotic-assisted radical cystectomy with a full intracorporeal orthotopic neobladder in a kidney transplant recipient. A 36-year-old man was diagnosed with muscle-invasive urothelial carcinoma 12 years after kidney transplantation. His immunosuppressive regimen consisted of everolimus, mycophenolate mofetil, and prednisolone. After cystectomy and left lymph node dissection, we used a U-shaped neobladder technique slightly modified to adapt to the fixed position of the renal transplant ureter. The surgical time was 305 min, and the blood loss was 200 ml. The patient was discharged 16 days after hospitalization with no surgical complications. Histological analysis revealed no UC (pT0N0) with disseminated carcinoma in situ. Seven months after the surgery, no signs of recurrence or distant/lymph node metastasis were observed. No urinary leakage with complete bladder emptying was reported. Serum creatinine clearance rate was 51 ml/min. Immunosuppressive regimen was not modified after surgery.