Robotic Assisted Radical Nephroureterectomy Melbourne
Robotic assisted radical nephroureterectomy is a minimally invasive surgical procedure to remove the entire kidney, the full ureter, and a small cuff of bladder tissue. It is the gold standard treatment for upper tract urothelial carcinoma (UTUC) — cancer arising from the lining of the kidney's collecting system (renal pelvis) or ureter. Using the da Vinci robotic surgical system, Dr Dias performs this complex cancer operation through small keyhole incisions, offering patients less pain, reduced blood loss, shorter hospital stays, and faster recovery compared with traditional open surgery.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (Urology), DrNB (Urology), FRCS (Urol), FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Minimally invasive approach with 5-6 small keyhole incisions
- Complete removal of kidney, ureter, and bladder cuff in one operation
- Significantly less postoperative pain than open surgery
- Shorter hospital stay (2-4 days vs 5-7 days for open surgery)
- Reduced blood loss with robotic precision and 3D vision
- Faster return to normal activities and work
- Equivalent cancer control outcomes to open surgery
- Better cosmetic result with minimal scarring
The Procedure
The procedure is performed under general anaesthesia and typically takes 3-4 hours. The patient is positioned on their side. Five to six small incisions (8-12 mm) are made in the abdomen, and the robotic instruments and high-definition 3D camera are inserted. The kidney is carefully mobilised and the renal blood vessels are controlled and divided. The ureter is followed down to the bladder, and a small cuff of bladder tissue is removed with the ureter to ensure complete excision. The bladder opening is then closed with sutures. The specimen is placed in a retrieval bag and removed through a slightly extended incision. A urinary catheter remains in place for 7-10 days to allow the bladder to heal.
Who Is a Candidate?
Robotic assisted radical nephroureterectomy is recommended for high-grade or invasive upper tract urothelial carcinoma, large tumours in the renal pelvis or ureter, multifocal tumours (cancer at multiple sites), tumours not suitable for kidney-sparing approaches, recurrent upper tract cancer after conservative treatment, or when diagnostic ureteroscopy shows concerning features. Dr Dias will review your CT urography, urine cytology, ureteroscopy findings, and overall health to confirm this is the right approach.
Recovery
Most patients are discharged within 2-4 days after surgery. A urinary catheter remains for 7-10 days until the bladder heals. Light walking is encouraged from day 1. Avoid lifting more than 5 kg for 4-6 weeks. Driving can typically resume at 2-3 weeks once you are comfortable and no longer taking strong pain medication. Return to office work at 2-4 weeks, and manual work at 4-6 weeks. Your remaining kidney will usually compensate, and most patients maintain good overall kidney function. Regular follow-up with cystoscopy and imaging is essential.
Risks & Considerations
Potential complications include temporary pain at incision sites, urinary tract infection, bleeding requiring transfusion (rare), urine leak from the bladder closure (usually resolves with prolonged catheter drainage), injury to surrounding organs, conversion to open surgery if needed, blood clots, hernia at an incision site, and reduced overall kidney function if the remaining kidney is impaired. Long-term, there is an increased risk of bladder cancer, which is why regular surveillance cystoscopy is important.