Abstract
In this report, to the best of our knowledge, we present the first case of genital-sparing robot-assisted radical cystectomy (RARC) using the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan) in a 78-year-old woman with muscle-invasive bladder cancer and a history of total hysterectomy. An anterior vaginal wall-sparing cystectomy and intracorporeal ileal conduit reconstruction were completed without complications. The postoperative course was uneventful, and pathological analysis revealed pT0N0M0. This case demonstrates the feasibility and safety of genital-sparing RARC with the hinotori system and highlights its potential role in preventing postoperative pelvic organ prolapse in selected female patients.