The article presents an assessment of the results of surgical treatment of bladder urothelial carcinoma using the Da Vinci Si robotic system. The experience of treating 11 patients who underwent robot-assisted cystectomy (RACE) was analysed. This study demonstrates the effectiveness of RACE due to minimal trauma, blood loss, transfusion frequency, and length of patient stay in the hospital.

Introduction. Bladder cancer is the 10th most common cancer worldwide. Radical cystectomy remains the gold standard for muscle invasive bladder cancer. The active use of robot-assisted cystectomy for treating patients with bladder cancer allows considering it as an alternative surgical option. The review is aimed at collecting and systematizing the evidence base for intracorporeal robot-assisted cystectomy. Materials and methods. MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar, and Web of Science databases were used with the PICO (Patient-InterventionComparison-Outcome) search strategy to identify research articles published between 2000 and 2022. The following keywords were used to search the medical literature: «robot-assisted cystectomy», «RARC», «orthotopic neobladder», «intracorporeal RARC», «extracorporeal RARC», «bladder cancer», «functional outcomes», and «clinical outcomes». The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Exclusion criteria: abstracts, review articles, editor's notes and comments, book chapters; experimental and laboratory studies on animals or cadavers. Results and disscussion. A total of 475 original articles were retrieved from the databases. Of them, 71 original articles were included in the analysis. The benefits and advantages of intracorporeal RARC at the intraoperative and postoperative period in comparison with RCE and extracorporeal RARC were reported. Functional and oncological outcomes following intracorporeal RARC are also comparable with RCE and extracorporeal RARC, suggesting the effectiveness and safety of the new surgical technology for treating patients with bladder cancer. Conclusions. The last decade has been marked with an active transition from traditional surgical techniques to robot-assisted surgery, enabling the precise performance, minimal trauma, and minimal intraoperative blood loss.

BACKGROUND: Increasing the effectiveness of the treatment of patients with kidney cancer is one of the main problems of oncourology. In its solution, great importance is attached to the development of new surgical technologies. AIM: The aim of the study to evaluate the results of extracorporeal kidney resection in conditions of pharmaco-cold ischemia with orthotopic renal replantation in kidney cancer patients. Our study is aimed at assessing the results of extracorporeal resection of the kidney under pharmaco-cold ischemia with orthotopic replantation of renal vessels in patients with kidney cancer. MATERIALS AND METHODS: 44 patients [of them, 70.5% (n = 31) men and 29.5% (n = 13) women] with kidney cancer were recruited in a study. All patients were treated between 2012 and 2021. The mean age of patients was 55.92 12.6 years. The stage was determined using the TNM system: pT1a-3bN0M0-1 G1-3. 75% (n = 33) of patients had stage pT1a1b; 11.4% (n = 5) pT2a2b, one patient was present with multiple lesions; 13.6% (n = 6) pT3a3b, one patient had up to 15 lesions in a single kidney. Two previously operated patients had cancer of a single kidney with intraluminal invasion. The mean R.E.N.A.L nephrometric score was 10.32 1.34. RESULTS: The duration of the surgery was 402.07 83.21 minutes. The duration of cold ischemia was 149.9 53.1 minutes. Blood loss 751.1 633.6 ml. Renal vascular replacement was performed in 13 patients. Postoperative complications II degree according to Clavien Dindo were detected in 36.6% (16) of patients. There was only one lethal outcome due to mesenteric thrombosis at day 4. Disease progressed in 6.8% (n = 3) of cases. The GFR level before surgery was on average 72.3 16.8 ml / (min 1.73 m2), in the early postoperative period 58.7 28.3 ml / (min 1.73 m2), 1 year after surgery 69.4 26.2 ml / (min 1.73 m2). One year after surgery it was 69.4 26.2 mol/l. The follow-up period ranged from 8 to 86 months (on average 58.7 19.1 months). CONCLUSIONS: This technique is effective in patients with multiple foci, centrally located and large tumors, for hard-to-reach localizations, as well as in patients with the impossibility of intracorporeal pharmaco-cold ischemia, peculiarities of organ blood supply.