AB179. SOH26AB_0133. Case report of simultaneous robotic ipsilateral adrenalectomy and partial nephrectomy for Conn’s syndrome and Bosniak IV renal cyst: a feasible combined minimally invasive approach

Background: Concurrent ipsilateral robotic adrenalectomy and partial nephrectomy is uncommon, particularly in patients with coexisting endocrine pathology and complex renal cysts. We present a case illustrating the safety and feasibility of a combined robotic approach using the Da Vinci Xi platform.

Case Description: A 40-year-old female with biochemically confirmed Conn’s syndrome was found to have a 2.2-cm left adrenal adenoma. Cross-sectional imaging also revealed a 4.3 cm × 2.9 cm Bosniak IV cyst in the ipsilateral kidney. Given the requirement for definitive management of both lesions, a single-session robotic left adrenalectomy and partial nephrectomy was planned. Using the Da Vinci Xi robotic platform, the adrenalectomy was completed first, followed by robotic partial nephrectomy to excise the cystic mass. Total operative time was approximately 3 hours, with minimal blood loss and no intraoperative complications. Postoperative recovery was uncomplicated, and the patient was discharged on postoperative day 4. Histopathology confirmed an adrenal cortical adenoma and a multilocular cystic renal neoplasm of low malignant potential.

Conclusions: This case demonstrates that simultaneous robotic adrenalectomy and partial nephrectomy can be safely and effectively performed in selected patients. In appropriately equipped centres, a combined minimally invasive approach may reduce the number of operative episodes, cumulative anaesthesia exposure, and overall hospital stay.

Keywords: Bosniak IV cyst; combined minimally invasive approach; Conn’s syndrome; robotic adrenalectomy; case report