Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

doi:10.1016/j.ajur.2016.05.004

Asian Journal of Urology, 2016, 3 (3): 156-166 doi: 10.1016/j.ajur.2016.05.004

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Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

Jason M. Sandberg, Ashok K. Hemal

Department of Urology, Wake Forest University School of Medicine, WinstoneSalem, NC, USA

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Abstract Robot-assisted radical cystectomy with intracorporeal urinary diversion (RARCICUD) has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncologic control while benefiting from minimally invasive surgical techniques. Inspired by earlier open and laparoscopic work, initial descriptions of RARC-ICUD were published in 2003, and have since been followed by multiple larger case series which have suggested promising outcomes for our patients. However, the rate of adoption has remained relatively slow when compared to other robotassisted procedures such as the radical prostatectomy, likely owing to longer operative times, operative complexity, costs, and uncertainty regarding oncologic efficacy. The operative technique for RARC-ICUD has evolved over the past decade and several high-volume centers have shared tips to improve efficiency and make the operation possible for a growing number of urologists. Though there are still questions regarding economic costs, effectiveness, and generalizability of outcomes reported in published data, a growing dataset has brought us ever closer to the answers. Here, we present our current operative technique for RARC-ICUD and discuss the state of the literature so that the urologist may hold an informed discussion with his or her patients.

Key words： Cystectomy Robotics Urinary bladder neoplasms Urinary diversion

Received: 23 March 2016 Published: 05 July 2016

Corresponding Authors: Ashok K. Hemal E-mail: ahemal@wakehealth.edu

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Jason M. Sandberg,Ashok K. Hemal. Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion[J]. Asian Journal of Urology, 2016, 3(3): 156-166.

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http://www.ajurology.com/EN/10.1016/j.ajur.2016.05.004 OR http://www.ajurology.com/EN/Y2016/V3/I3/156

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