Robotic radical cystectomy with intracorporeal urinary diversion: beyond the initial experience

Robotic assisted radical cystectomy (RARC) has gained popularity within minimally-invasive urologic surgery, and has been shown to be a safe procedure with similar oncologic outcomes when compared to the conventional open standard. While initial RARC feasibility and outcomes studies were performed w...

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Published inTranslational andrology and urology Vol. 9; no. 2; pp. 942 - 948
Main Authors Murthy, Prithvi B, Bryk, Darren J, Lee, Byron H, Haber, Georges-Pascal
Format Journal Article
LanguageEnglish
Published China AME Publishing Company 01.04.2020
Subjects
Review on Robotic-assisted Urologic Surgery
intracorporeal
bladder cancer
Minimally-invasive surgery
urinary diversion
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Summary:Robotic assisted radical cystectomy (RARC) has gained popularity within minimally-invasive urologic surgery, and has been shown to be a safe procedure with similar oncologic outcomes when compared to the conventional open standard. While initial RARC feasibility and outcomes studies were performed with extracorporeal urinary diversion, intracorporeal urinary diversion (ICUD) is becoming increasingly utilized. Reported benefits of an intracorporeal approach include decreased blood loss and a lower incidence of ureteral strictures. While ICUD is technically challenging, many have overcome the learning curve associated with this procedure via a mentorship model and a dedicated operative team. Techniques vary between institutions, and ileal conduit, continent cutaneous and orthotopic continent (neobladder) diversions have all been performed. Herein, we describe the learning curve, technical points, and unique complications associated with ICUD.
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Contributions: (I) Conception and design: PB Murthy, BH Lee, GP Haber; (II) Administrative support: BH Lee, GP Haber; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
ISSN:2223-4691
2223-4683
2223-4691
DOI:10.21037/tau.2019.11.36