Robot-assisted laparoscopic radical cystectomy: initial experience on 27 consecutive patients

Mottrie, Alexandre; Carpentier, Paul; Schatteman, Peter; Fonteyne, E.; Suttmann, H.; Stöckle, Michael; Siemer, S.

doi:10.1007/s11701-007-0035-9

Cited by 14 publications

(5 citation statements)

References 21 publications

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“…In some early, small series, Mottrie et al [9] and Murphy et al [12] reported sufficient erections in six of seven and three of four men, respectively. Similar to well-described literature on RARP, Table 8 summarizes comparative studies evaluating lymph node yield after ORC, LRC, and RARC.…”

Section: Potency Recovery After Robot-assisted Radical Cystectomymentioning

confidence: 95%

“…Only three of six series reported using a distinct definition for continence, which was generally no pad or one pad (safety) per day. One of the earliest RARC series reported an 86% continent rate (seven of eight men) after 3.5 mo [9]. More recent series published 6-mo continence rates of 48-100% for daytime continence and 11-100% for nighttime continence.…”

Section: Functional Informationmentioning

confidence: 97%

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Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

et al. 2015

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Context: Although open radical cystectomy (ORC) is still the standard approach, laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) are increasingly performed.Objective: To report on a systematic literature review and cumulative analysis of pathologic, oncologic, and functional outcomes of RARC in comparison with ORC and LRC.Evidence acquisition: Medline, Scopus, and Web of Science databases were searched using a free-text protocol including the terms robot-assisted radical cystectomy or da Vinci radical cystectomy or robot* radical cystectomy. RARC case series and studies comparing RARC with either ORC or LRC were collected. A cumulative analysis was conducted.Evidence synthesis: The searches retrieved 105 papers, 87 of which reported on pathologic, oncologic, or functional outcomes. Most series were retrospective and had small case numbers, short follow-up, and potential patient selection bias. The lymph node yield during lymph node dissection was 19 (range: 3-55), with half of the series following an extended template (yield range: 11-55). The lymph node-positive rate was 22%. The performance of lymphadenectomy was correlated with surgeon and institutional volume. Cumulative analyses showed no significant difference in lymph node yield between RARC and ORC. Positive surgical margin (PSM) rates were 5.6% (1-1.5% in pT2 disease and 0-31% in pT3 and higher disease). PSM rates did not appear to decrease with sequential case numbers. Cumulative analyses showed no significant difference in rates of surgical margins between RARC and ORC or RARC and LRC.Neoadjuvant chemotherapy use ranged from 0% to 31%, with adjuvant chemotherapy used in 4-22% of patients. Only six series reported a mean follow-up of >36 mo. Three-year disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates were 53-74%, 68-83%, and 72-80%, respectively. The 5-yr DFS, CSS, and OS rates were 53-74%, 66-80%, and 39-66%, respectively. Similar to ORC, disease of higher pathologic stage or evidence of lymph node involvement was associated with worse survival. Very limited data were available with respect to functional outcomes. The 12-mo continence rates with continent diversion were 83-100% in men for daytime continence and 66-76% for nighttime continence. In one series, potency was recovered in 63% of patients who were evaluable at 12 mo. Conclusions

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Section: Potency Recovery After Robot-assisted Radical Cystectomymentioning

confidence: 95%

Section: Functional Informationmentioning

confidence: 97%

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

et al. 2015

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“…Continence figures are relevant to those patients undergoing orthotopic neobladder at the same time as male NS RARC and satisfactory continence is defined in the studies to be dry enough to maintain with a maximum of one pad per day. In this review, 85.06% day time continence rate (range 54.5%-100%) and 72.48% night time continence rate (range 46.7%-88%) were noted overall in patients whose NVBs were preserved [13,17,18,[20][21][22]26,[29][30][31][33][34][35][36][37][38][39][40] . This is in contrast to the results of some studies, for example, Tyritzis et al [38] , who noted no significant difference in continence rates between their NS and non-NS groups of patients with 88.2% and 88.9% respectively for day time continence rates at 12 months.…”

Section: Discussionmentioning

confidence: 96%

Functional and oncological outcomes with male nerve sparing robotic assisted radical cystectomy

Thinagaran¹,

Maqboul²,

Dovey³

et al. 2021

MIS

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Aim:In keeping with the ethos of surgical oncology, male nerve sparing (NS) robotic assisted radical cystectomy (RARC) aims to maximise functional outcomes without sacrificing oncological outcomes. This review details the surgical technique of male NS RARC as well as discussing strategies that may be employed in tandem with surgery to improve post-operative recovery and longer-term quality of life.Methods: An OVID/EMBASE database search was done with key words of robotic, cystectomy, male and nerve sparing. Publications with no description of post-operative functional outcome were excluded. A total number of 25 relevant publications were selected investigating male NS RARC, assessing functional outcomes along with other surgical standard indicators.Results: Most series contained small numbers of patients with largely retrospective data and the associated bias of selection. Mean follow up of 27.06 months (range 2.8-58 months) was noted overall. Study design, technique, definitions and measurements of continence and erectile function are heterogeneous across series. With a mean follow up of 27.06 months (range 2.8-58 months), a post-operative satisfactory erectile function of 54.32% (range 9%-100%) and satisfactory day time continence of 90% (range 54.5%-100%) and night time continence of 80.55% (range 46.7%-88%) was found with a mean positive surgical margin rate of only 1.8% (range 0%-6.4%). Conclusion:Male NS RARC for appropriately selected patients will offer good functional outcomes. Results from the series reviewed suggest the technique is both feasible and safe, without compromising longer term oncological results.

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“…Beyond the field of ophthalmology, the da Vinci system has been used by neurosurgeons to investigate the feasibility of minimally invasive skull base surgery using a supraorbital trans-eyebrow keyhole approach 16. Robot-assisted muscle surgery has also been reported for many large muscles, such as latissimus dorsi, diaphragm, Heller, bladder, vagina, and pelvic muscles 17–19…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Simulated Strabismus Surgery

Bourcier

Chammas

Gaucher

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose This study aims to investigate the feasibility of robot-assisted simulated strabismus surgery using the new da Vinci Xi Surgical System and to report what we believe is the first use of a surgical robot in experimental eye muscle surgery. Methods Robot-assisted strabismus surgeries were performed on a strabismus eye model using the robotic da Vinci Xi Surgical System. On the lateral rectus of each eye, we performed a procedure including, successively, a 4-mm plication followed by a 4-mm recession of the muscle to end with a 4-mm resection. Operative time from conjunctival opening to closing and successful completion of the different steps with or without complications or unexpected events were assessed. Results Robot-assisted strabismus procedures were successfully performed on six eyes. The feasibility of robot-assisted simulated strabismus surgery is confirmed. The da Vinci Xi system provided the appropriate dexterity and operative field visualization necessary to perform conjunctival and Tenon's capsule opening and closing, muscle identification, suturing, desinsertion, sectioning, and resuturing. The mean duration to complete the whole procedure was 27 minutes (range, 22–35). There were no complications or unexpected intraoperative events. Conclusions Experimental robot-assisted strabismus surgery is technically feasible using the new robotic da Vinci Xi Surgical System. This is, to our knowledge, the first use of a surgical robot in ocular muscle surgery. Translational Relevance Further experimentation will allow the advantages of robot-assisted microsurgery to be identified while underlining the improvements and innovations necessary for clinical use.

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Robot-assisted laparoscopic radical cystectomy: initial experience on 27 consecutive patients

Cited by 14 publications

References 21 publications

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

Systematic Review and Cumulative Analysis of Oncologic and Functional Outcomes After Robot-assisted Radical Cystectomy

Functional and oncological outcomes with male nerve sparing robotic assisted radical cystectomy

Robot-Assisted Simulated Strabismus Surgery

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