Robotic-assisted laparoscopic radical cystoprostatectomy and extracorporeal continent urinary diversion: highlight of surgical techniques and outcomes

Int J Med Robot. 2010 Sep;6(3):315-23. doi: 10.1002/rcs.335.

Abstract

Background: We report our technique for robotic-assisted laparoscopic radical cystoprostatectomy (RARCP) and extracorporeal urinary diversion and present their clinical outcomes.

Methods: Between October 2003 and December 2008 we performed 58 RARCPs with extracorporeal continent urinary diversion. Preoperative, operative and postoperative data was evaluated.

Results: Mean patient age was 68 (range 46-89) years, with an average American Society of Anesthesiologists classification of 2.9. Mean operative time was 8 (range 5-11) h. Median blood loss was 450 ml. Thirteen patients received intra-operative blood transfusions and 22 patients received peri-operative blood transfusions. Continent urinary diversions were performed by means of the Studer technique (n = 42) or Indiana pouch (n = 16). Mean number of lymph nodes examined on lymphadenectomy was 27 (range 0-52).

Conclusions: Our RARCP and continent diversion technique is a safe and feasible option for primary urothelial carcinoma of the bladder. Oncological and surgical outcomes are comparable to open cystectomy series.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / methods
  • Aorta, Abdominal
  • Cystectomy / methods
  • Humans
  • Iliac Artery
  • Male
  • Middle Aged
  • Patient Positioning
  • Prostatectomy / methods*
  • Robotics / instrumentation
  • Robotics / methods*
  • Safety
  • Surgical Procedures, Operative / methods*
  • Sutures
  • Treatment Outcome
  • United States / epidemiology
  • Ureter / surgery
  • Urinary Bladder Neoplasms / epidemiology
  • Urinary Bladder Neoplasms / surgery
  • Urinary Diversion / methods*
  • Urinary Incontinence / prevention & control*