Synchronous pyeloplasty, bladder diverticulectomy, and simple prostatectomy - All retroperitoneal from a single incision

• Single port robot makes concurrent multisite surgery more feasible than multiport platforms. • Concurrent multisite surgery offers patients the advantage of quicker recovery time without added risks of complications. • The single port robot is able to access multi quadrant surgical fields through a single retroperitoneal incision decreasing risk of bowel injury. Synchronous Pyeloplasty, Bladder Diverticulectomy, and Simple Prostatectomy – A Single-Incision Retroperitoneal Approach Using the da Vinci SP Robot Authors: Steve Oglivy, PA; Gabriela Mazur, DO; Parker Adams, DO; Robenson Nguyen; Ryan J. Nelson, DO Institution: Henry Ford Macomb Urology Department, Clinton Township, Michigan Introduction The da Vinci® Single Port (SP) robotic system enables multi-quadrant access through a single incision. We present a novel case of synchronous robotic pyeloplasty, bladder diverticulectomy, and simple prostatectomy performed retroperitoneally, eliminating the need for multiple procedures. Methods A 72-year-old male with symptomatic left ureteropelvic junction obstruction (UPJO), a 14 cm bladder diverticulum, and benign prostatic hyperplasia (50 g) underwent a single-stage robotic procedure. A 6 cm retroperitoneal flank incision was used. Running ureteropelvic anastomosis with firefly fluorescence to confirm tissue perfusion. Standard diverticulectomty and transvesical prostatectomy performed. 24fr 3-way foley catheter and 19fr round JP drain used. Admitted overnight for observation and continuous bladder irrigation. Results Operative time was 5 h, with 140 min of console time. Blood loss was 100 mL. The patient was discharged within 24 h. A minor urine leak on postoperative day 18 resolved conservatively by day 28. No major complications occurred within 90 days. Conclusion This case demonstrates the feasibility of a single-incision, synchronous robotic procedure using the SP platform, reducing surgical burden and recovery time while expanding robotic applications in urology.