Canada’s First Robotic Assisted Totally Intracorporeal Orthotopic Ileal Neobladder

Abstract

Despite robotic-assisted radical cysto-prostatectomy being performed in several centres, the urinary diversion is most often performed extra-corporeal. A robotic intra-corporeal ileal neobladder is technically demanding and long-term functional outcome data is lacking. We performed a robotic intra-corporeal ileal neobladder in a 73-year-old man for muscle invasive non-metastatic bladder cancer. The total operative time was 6 hours 8 minutes. The estimated blood loss was 900 mL. There were no complications and he was discharged on day 12. The principles of open neobladder surgery were maintained, however key modifications were used to reduce technical difficulty and enable timely completion. We found that robotic intracorporeal ileal neobladder can be safely performed with an experienced robotic unit.

Current status of robotic assisted radical cystectomy with intracorporeal ileal neobladder for bladder cancer

“…The final number of papers included in this study was 8 (three case series and five case reports) [8][9][10][11][12][13][14][15]. Although the impact of single case reports in a systematic review process is low, we decided to include 5 case reports as the available data about robotic neobladder is still limited.…”

“…In all series, performance of the urethral-enteric anastomosis was carried out before pouch configuration [9,10] except for Butt ZA et al [8] who reconfigurated the pouch first. In all cases an ileal loop between 50 and 65 cm length was isolated using an Endo GIA [8][9][10][11][12][13][14][15]. In 97.5% of the cases, a "sideto-side" ileo-ileal anastomosis was performed using Endo GIA staplers [9][10][11][12][13][14][15].…”

“…In all cases an ileal loop between 50 and 65 cm length was isolated using an Endo GIA [8][9][10][11][12][13][14][15]. In 97.5% of the cases, a "sideto-side" ileo-ileal anastomosis was performed using Endo GIA staplers [9][10][11][12][13][14][15]. Pouch configuration was performed using running sutures [8][9][10][11][12][13][14][15].…”

“…In 97.5% of the cases, a "sideto-side" ileo-ileal anastomosis was performed using Endo GIA staplers [9][10][11][12][13][14][15]. Pouch configuration was performed using running sutures [8][9][10][11][12][13][14][15]. The uretero-ileal anastomosis was performed according Wallace technique after transpositioning of the left ureter below sigmoid mesocolon in (196/203; 96.6%) patients with Studer pouch [9,10,12,13].…”

“…Pouch configuration was performed using running sutures [8][9][10][11][12][13][14][15]. The uretero-ileal anastomosis was performed according Wallace technique after transpositioning of the left ureter below sigmoid mesocolon in (196/203; 96.6%) patients with Studer pouch [9,10,12,13]. In 7 cases it was performed separately without transposing the left ureter below the mesentery.…”