Robotic-assisted laparoscopic radical cystoprostatectomy and extracorporeal continent urinary diversion: highlight of surgical techniques and outcomes.
BACKGROUND
We report our technique for robotic-assisted laparoscopic radical cystoprostatectomy (RARCP) and extracorporeal urinary diversion and present their clinical outcomes.


METHODS
Between October 2003 and December 2008 we performed 58 RARCPs with extracorporeal continent urinary diversion. Preoperative, operative and postoperative data was evaluated.


RESULTS
Mean patient age was 68 (range 46-89) years, with an average American Society of Anesthesiologists classification of 2.9. Mean operative time was 8 (range 5-11) h. Median blood loss was 450 ml. Thirteen patients received intra-operative blood transfusions and 22 patients received peri-operative blood transfusions. Continent urinary diversions were performed by means of the Studer technique (n = 42) or Indiana pouch (n = 16). Mean number of lymph nodes examined on lymphadenectomy was 27 (range 0-52).


CONCLUSIONS
Our RARCP and continent diversion technique is a safe and feasible option for primary urothelial carcinoma of the bladder. Oncological and surgical outcomes are comparable to open cystectomy series.
Josephson
D Y
DY
Department of Urology and Urologic Oncology, City of Hope, Duarte, CA 91010, USA. djosephson@coh.org
Chen
J A
JA
Chan
K G
KG
Lau
C S
CS
Nelson
R A
RA
Wilson
T G
TG
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D001012:Aorta, Abdominal; D015653:Cystectomy / Q000379:methods; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011468:Prostatectomy / Q000379:methods*; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D012449:Safety; D013514:Surgical Procedures, Operative / Q000379:methods*; D013537:Sutures; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014513:Ureter / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000517:prevention & control*