Bladder Diverticulum Robotic Surgery: Systematic Review of Case Reports

Sierra, Jesús Moreno; Romo, I. Galante; Ortiz-Oshiro, Elena; Castillon-Vela, Ignacio; Fernández‐Pérez, Cristina; Silmi-Moyano, Á.

doi:10.1159/000319421

Cited by 24 publications

(5 citation statements)

References 44 publications

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“…Laparoscopy can be extraperitoneal [ 6 , 8 ], intraperitoneal (= transperitoneal) [ 2 , 3 ] or suprapubic transvesical [ 18 – 20 ]. Pure laparoscopy can be replaced by robotic-assisted bladder diverticulectomy [ 1 , 9 , 11 , 12 , 14 , 18 , 19 , 21 – 23 ]. Attempts to introduce laparoendoscopic single site surgery (LESS) have also been documented [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate.

Hora¹,

Eret²,

Stránský³

et al. 2015

Videosurgery and Other Miniinvasive Techniques

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IntroductionPseudodiverticulum of the urinary bladder is mostly a complication of subvesical obstruction (SO). The gold standard of treatment was open diverticulectomy with adenectomy. A more contemporary resolution is endoscopic, in two steps: the first transurethral resection of the prostate (TURP), the second laparoscopic diverticulectomy (LD).AimTo present a one-session procedure – photoselective vaporisation of the prostate (PVP) with LD.Material and methodsFrom 1/2011 to 6/2014, 14 LDs were performed: 1 LD only, 1 with laparoscopic radical prostatectomy, 12 combined with treatment of benign prostatic hyperplasia (BPH), 4 cases of TURP and LD in the second period. In 8 cases, PVP and LD in one session were combined. These 8 cases are presented. 3D CT cystography was used as a gold standard for assessment of diverticulum.ResultsThe mean age was 66.5 ±5.5 (57.3–75.1) years, the mean size of the diverticulum 61.8 ±22.1 (26–90) mm. The procedure starts in the lithotomy position. It includes PVP and stenting of the ureter(s). Changing of position and laparoscopy follows: four ports, transperitoneal extravesical approach. Photoselective vaporisation of the prostate was performed using the Green Light Laser HPS (1x) or XPS with cooled fibre MoXy (7x). The mean delivered energy in PVP was 205.1 ±106.4 (120–458) kJ. The mean time of operation was 165.0 ±48.5 (90–255) min. No postoperative complications were observed. One patient underwent TUR incision after 1 year for sclerosis of the bladder neck.ConclusionsPseudodiverticulum of the urinary bladder (with or without SO) is a relatively rare disease. One session of PVP (Green Light Laser XPS, MoXy fibre) and laparoscopic (transperitoneal extravesical) diverticulectomy is the preferred method for treatment of subvesical obstruction due to BPH and bladder diverticulum at our institution.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate.

Hora¹,

Eret²,

Stránský³

et al. 2015

Videosurgery and Other Miniinvasive Techniques

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“…By providing a systematic review of published case reports, Moreno Sierra et al . recently reported that robotically‐assisted bladder diverticulectomy is a safe, effective and minimally invasive technique, although the cost is higher than for laparoscopic surgery 22 …”

Section: Discussionmentioning

confidence: 99%

Robotic bladder diverticulectomy: Technique and surgical outcomes

et al. 2011

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Objectives: Indications for surgical treatment of bladder diverticula include tumor, lower urinary tract symptoms refractory to medical treatment, renal dysfunction or recurrent urinary tract infections. We describe the technique and report the outcomes of robotic bladder diverticulectomy at our institution. Methods: A chart review of patients who underwent robotic bladder diverticulectomy at our institution from 2007 to 2010 was carried out. Indications for the procedure were: lower urinary tract symptoms (LUTS) not responding to medical treatment (2 patients), ureteral obstruction (1 patient), tumor arising in a diverticulum (2 patients) and diverticulum secondary to neurogenic bladder (1 patient). One patient also had renal dysfunction associated with ureteral insertion into the diverticulum and therefore underwent ipsilateral ureteroneocystostomy. Other additional procedures included transurethral resection of the prostate (1 patient) and bilateral pelvic lymph node dissection (1 patient). Perioperative and postoperative outcomes were analyzed. Results: Six patients (median age 61.5 years, range 19-75) underwent da Vinci diverticulectomy using a transperitoneal approach without the need for open conversion. Median operative time was 232 min (135-360 min.). Median estimated blood loss was 100 mL (50-150 mL). The Foley catheter was removed after a negative cystogram and median time to catheter removal was 7 days (7-12 days). Median hospital stay was 3 days (2-5 days). The only complication was a urinary tract infection managed with antibiotics. Conclusions: Robotic surgery represents a reasonable minimally invasive treatment option for resection of bladder diverticula when indicated.

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“…[54,55] The current literature has several small robot-assisted laparoscopic diverticulectomy series in adults. [56] Pediatric reports are scarce, with the only published robotic bladder diverticulum repair coming from Meeks et al in 2009. [57] Potential advantages are 3D visualization and improved suturing and dissection dexterity.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic-assisted laparoscopic surgery in pediatric urology: an update

Kojima¹,

Khurgin²,

Casale³

2012

Turkish Journal of Urology

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Laparoscopic procedures for urological diseases in children, such as nephrectomy, pyeloplasty and orchiopexy, have proven to be safe and effective with outcomes comparable to open procedures. The main drawback has been the relatively steep learning curve for this procedure that is associated with technical difficulties such as suturing and anastomosis. More recently, robotic-assisted laparoscopic surgery (RAS) has gained enormous popularity in adult urology and is increasingly being adopted around the world; however, few pediatric urology series have been reported. RAS has several advantages over conventional laparoscopic surgery, mainly the simplification and precision of exposure and suturing. The robotic arms move in real time with an increased degree of freedom and a magnified, 3-dimensional view. These features render RAS ideal for complex reconstructive surgery in a pediatric urological population. This review discusses the role of RAS in pediatric urology, provides technical aspects of RAS and offers a critical summary of current knowledge on its indications and outcomes. Almost all operations that are classically performed as open or conventional laparoscopic reconstructive surgeries for children with urological anomalies could be replaced by RAS and this procedure may be established as an alternative minimally invasive surgery in the future.Key words: Laparoscopy; minimally invasive surgery; pediatrics; robotics; urinary tract reconstruction; urology. ÖZETÇocuklarda nefrektomi, piyeloplasti ve orşiopeksi gibi ürolojik hastalıklar için laparoskopik prosedürlerin, açık prosedürlerle kıyaslanabilir sonuçlar ile birlikte, güvenli ve etkili olduğu kanıtlanmıştır. Bu prosedür-lerin, sütür atma ve anastamoz gibi teknik zorluklarla ilişkili göreceli dik öğrenme eğrisi olması başlıca dezavantaj olmaktadır. Son zamanlarda, robot yardımlı laparoskopik cerrahi (RAS) erişkin ürolojisinde olağanüstü bir popülerlik kazanmıştır ve bütün dünyada giderek artan bir şekilde kabul görmektedir; buna karşın, bir kaç pediatrik üroloji serisi yayınlanmıştır. RAS konvansiyonel laparoskopik cerrahiye kıyasla bir kaç avantaja sahiptir; bunların başlıcaları pozlama ve sütur atmanın kolaylığı ve hassasiyetidir. Robot kollar artmış bir serbestlik derecesinde ve büyütülmüş 3 boyutlu bir bakış açısıyla gerçek zamanlı olarak hareket etmektedir. Bu özellikler RAS'ı pediatrik ürolojik populasyonda kompleks rekonstrüktif cerrahi için ideal yapmaktadır. Bu derleme pediatrik ürolojide RAS'ın rolünü tartışmakta, RAS'ın teknik yönlerini bildirmekte ve endikasyonları ve sonuçları hakkında güncel bilgilerin eleştirel bir özetini sunmaktadır. Ürolojik anomalisi olan çocuklar için açık veya konvansiyonel laparoskopik rekonstrüktif cerrahi şeklinde klasik olarak yapılan hemen hemen tüm operasyonların yerine RAS yapılabilir ve bu prosedür gelecekte alternatif bir minimal invaziv cerrahi olarak yerleşebilir.

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Bladder Diverticulum Robotic Surgery: Systematic Review of Case Reports

Cited by 24 publications

References 44 publications

Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate.

Laparoscopic urinary bladder diverticulectomy combined with photoselective vaporisation of the prostate.

Robotic bladder diverticulectomy: Technique and surgical outcomes

Robotic-assisted laparoscopic surgery in pediatric urology: an update

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