Robot– assisted radical cystectomy –  surgical principles and evaluation of oncological, functional and complication outcomes


Authors: S. I. Tyritzis;  N. P. Wiklund
Published in: Urol List 2014; 12(2): 40-44

Overview

In 2011, the EAU Guidelines were describing robot– assisted radical cystectomy (RARC) as an experimental procedure. Many centers were still in their learning curve and safe conclusions about the safety and efficacy of the procedure could not be drawn. In 2012, RARC was an option, but not proven. But, in 2013, RARC is a feasible and safe operation. It is advocated that RARC, being a highly complex surgery, consisting of multiple steps, should be performed by a devoted team of robotic surgeons, nurses and anesthetists, which are all experienced and have mastered the above steps. Literature data show that RARC trends to be superior in blood loss, hospitalization, and early and late complication rates. Additionally, there seems to be an advantage of the totally intracorporeal technique of urinary diversion compared to the extracorporeal technique. Moreover, recent long‑term oncological results show similar outcomes for RARC to open cystectomy. Until, high‑powered, randomized controlled trials with sufficient follow‑up will be published, open radical cystectomy remains the gold standard. In this review paper, we will describe our technique step by step, providing useful tips and tricks and present an update on multiple outcomes of the operation.

Key words:
robot-assisted radical cystectomy, urinary diversion, oncological and functional results


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Paediatric urologist Urology
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