We present the first report of robot-assisted removal of a large seminal vesicle cyst with ipsilateral renal agenesis, associated with ectopic ureter and a Müllerian cyst of the vas deferens in a 39-year-old man. With the use of the same transperitoneal approach as robot-assisted laparoscopic radical prostatectomy and 5 ports, it was possible to remove this rare and complex malformation of the mesonephric duct that was causing pelvic pain and urogenital infection. The advantages over conventional laparoscopy consist of easier instrument manipulation, greater movement precision resulting in calibrated use of thermal energy, ease of suturing, and better visualization because of higher magnification and 3-dimensional imaging.
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