Introduction. Prostate cancer is one of the most common oncological diseases in men. Robot-assisted radical prostatectomy is associated with better urinary continence, compared with open and laparoscopic technique. Their oncologic outcomes are comparable. However, urinary incontinence after this surgery remains a challenge. Aim. To present a new technique of anterior reconstruction of pelvic structures during robot-assisted radical prostatectomy and evaluate its efficacy and safety. Materials and methods. We evaluated the results of treatment of 50 patients after robot-assisted radical prostatectomy for localised prostate cancer. They treated during the period from November 2020 till June 2021 in one medical centre. All surgeries were performed using transperitoneal access with anatomical-sparing technique. The anterior reconstruction of pelvic structures was performed with endopelvic fascia. All patients were informed about the study and signed the consent. The main perioperative parameters were assessed, as well as early oncological and functional outcomes. Evaluation the results of immediate and early urinary continence was carried out on the basis of questionnaire data. Results. The mean operative time was 140 min (110–170 min), mean console time was 72,5 min (45–100 min), the duration of the anterior reconstruction was 5,25 min (3,0–7,5 min). The average intraoperative blood loss was 50 ml (15–75 ml). There were no III-IV Clavien-Dindo complications. The 74% of patients were continent immediately after the surgery. The continent rate in a month after the surgery was 93%. Conclusion. This technique of robotic-assisted radical prostatectomy with anterior reconstruction is safe and effective. It does not increase the risk of complications and have no detrimental effect the oncological outcomes, while its early functional results are promising.

Bladder diverticulum in children is rarely encountered in the practice of a pediatric urologist. If the bladder diverticulum has clinical manifestations (pain, urinary tract infection, hematuria, voiding dysfunction, vesicoureteral reflux, or obstruction of the ureterovesical anastomosis), then surgical treatment is indicated. Recently, more and more publications began to appear on the removal of the bladder diverticulum using laparoscopic or vesicoscopic access. Several foreign publications report on the removal of a bladder diverticulum in children using a robotic approach. A 9-year-old boy with a diagnosis of bladder diverticulum underwent surgical intervention in the volume of robot-assisted bladder diverticulectomy in January 2020 at the Almazov National Medical Research Centre. Ports da Vinci 12 and two 8 mm were used, as well as an assistant 5 mm port, which were installed in typical places for lower abdominal surgery. The duration of the operation was 135 minutes. Console time - 75 minutes. The volume of blood loss is 20 ml. The patient was in the intensive care unit for a day. The urethral catheter was removed on the 7th day after the operation. Urination independent, free; phenomena of delay, incontinence were not noted. The patient was discharged on the 9th postoperative day in a satisfactory condition. At the control examination after a year at the place of residence, she does not complain, urination is not disturbed, there are no pathological changes in the ultrasound of the kidneys and bladder. Robot-assisted bladder diverticulectomy in children is a feasible, effective and safe treatment option in expert centers with extensive experience in robotic surgery. The described clinical case of bladder diverticulectomy is the first in Russia performed using a robotic system in pediatric practice.