Robotic radical cystectomy and urinary diversion in the management of bladder cancer

Hemal, Ashok K.; Abol‐Enein, Hassan; Tewari, Ashutosh; Shrivastava, Aviral; Shoma, Ahmed M.; Ghoneim, Mohamed A.; Menon, Mani

doi:10.1016/j.ucl.2004.06.009

Cited by 110 publications

(58 citation statements)

References 21 publications

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“…The potential advantages of robotic assistance include lower blood loss, reduced need for intraoperative fluids, smaller incisions, reduced exposure of bowel to the exterior, and the ability for the surgeon to perform the operation more ergonomically. 174 The urinary diversion can be performed intracorporeally, but because of prolonged operative times, this is usually performed extracorporeally by extending one of the incisions. 175 The main concerns for robot-assisted radical cystectomy are compromised lymph node dissections and suboptimal oncologic outcomes.…”

Section: Robotic Cystectomymentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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Section: Robotic Cystectomymentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

View full text Add to dashboard Cite

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“…32 Since then several other authors have published their initial experiences with this procedure. [33][34][35][36] The procedure is safe with acceptable operating times and good shortterm functional and oncological results. [37][38][39][40] In 2008 Elhage et al described their surgical technique and looked at the financial aspect from a British perspective.…”

Section: Urologymentioning

confidence: 95%

Robotic surgery

and

Verheijen

2008

BJOG

101

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Over the past decade, there has been an exponential growth of robot-assisted procedures and of publications concerning roboticassisted laparoscopic surgery. From a review of the available literature, it becomes apparent that this technology is safe and allows more complex procedures in many fields of surgery, be it at relatively high costs. Although randomised controlled trials in gynaecology are lacking, available evidence suggests that particularly in gynaecology robotic surgery might not only reduce morbidity but also be cost effective if performed in high-volume centres. Training in robotic surgery and programs for safe and effective implementation are necessary.

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“…We used the technique previously described with some modiWcation [8][9][10] involving the use of the fourth robotic arm and exclusively extracorporeal creation of ileal conduit and orthotopic neobladder. The fourth robotic arm port is placed as a mirror image to the right 12-mm port, on the left side.…”

Section: Techniquementioning

confidence: 99%

“…They also described the technique of uterus and vagina preserving RRC in female patients [9]. Subsequently, Hemal et al [10] published their experience of RRC in 2004. We acquired a da Vinci ® S TM robot (Intuitive Surgical, Sunnyvale, CA, USA) in our department recently and explored its use.…”

Section: Introductionmentioning

confidence: 99%

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

2008

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One of the recent developments in the da Vinci robot surgical system is the introduction of a more ergonomic four-arm robot. We report our experience of robotic radical cystectomy (RRC) for bladder cancer using the four-arm da Vinci(®) S(TM) robot (Intuitive Surgical, Sunnyvale, CA, USA). Beginning September 2006, we performed robotic radical cystectomy and bilateral pelvic lymphadenectomy in six patients with muscle-invasive bladder cancer using da Vinci(®) S(TM) robot. Ileal conduit diversion was made in five patients, and sigmoid orthotopic neobladder in one patient. The operating surgeon used the fourth arm for various steps such as bladder retraction for defining vascular pedicles, separating cystoprostatectomy specimen off the rectum, and while performing urethroneovesicostomy. The mean operative time was 12, 148, 44, and 126 min for docking, cystectomy, lymphadenectomy, and urinary diversion, respectively. Median blood loss was 200 ml. Mean hospital stay was 9.2 days. Surgical margins were negative in all the patients. The mean number of nodes removed was 12 (4-19). Histopathology revealed transitional cell carcinoma in all the patients (pT2a-1, pT2b-3, pT3a-2). Robotic radical cystectomy is feasible with new four-arm da Vinci(®) S(TM) surgical system. The operating surgeon can use the fourth arm of the robot as a substitute for the second assistant during the procedure. However, a patient-side surgeon with adequate training in laparoscopic skills is mandatory.

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Robotic radical cystectomy and urinary diversion in the management of bladder cancer

Cited by 110 publications

References 21 publications

Bladder Cancer in 2010: How Far have We Come?

Bladder Cancer in 2010: How Far have We Come?

Robotic surgery

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

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