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Arterial hypertension is a major cause of mortality and morbidity worldwide. Medical therapy is the most common treatment. However, in some cases there is a persistent high blood pressure despite medical therapy. These patients with medication refractory arterial hypertension can be treated by renal denervation. Until now an endovascular approach has been used. There are however limitations in eligibility based on vascular or anatomical anomalies. For these patients, as well as other patients eligible for renal denervation, robot-assisted renal denervation has the potential to become a surgical treatment option based on our findings.

Objective: The urachus is a remnant of the embryological allantois and usually regresses before birth. Persisting urachal abnormalities can lead to infection or even malignancy. Because malignant deterioration becomes more likely with age, resection is advised in adults. The spectrum of urachus neoplasms consists of benign to borderline benign mucinous cystic tumors, to low-grade malignant or malignant mucinous cystadenocarcinomata. There are several surgical procedures for dissection an urachus remnant. We performed a robot-assisted laparoscopic partial cystectomy with simultaneous cystoscopy for a lesion at the dome of the urinary bladder. Patient and surgical procedure: We present a case of a 59-year-old woman who was diagnosed with recurrent breast carcinoma. A staging PET-CT revealed a mass at the dome of the urinary bladder. We performed a robot-assisted laparoscopic partial cystectomy with cystoscopic guidance. The lesion was excised en-bloc with the median umbilical ligament. Results: The patient was discharged one day after surgery, there were no complications. The Foley bladder catheter was removed five days postoperatively, after cystography showed no extravasation. Histopathological diagnosis reported a rare mucinous cystic tumor of low malignant potential. The patient experienced no change in micturition six weeks after surgery. Discussion: A robot-assisted laparoscopy with cystoscopic assistance is a safe and feasible technique for a maximal bladder-sparing partial cystectomy.