Intravesical methylene blue facilitates precise identification of the diverticular neck during robot-assisted laparoscopic bladder diverticulectomy.
BACKGROUND
The aim of this report is to describe our surgical technique for robot-assisted laparoscopic bladder diverticulectomy. In this technique, methylene blue is instilled into the bladder to aid in intra-abdominal identification of the diverticular neck.


METHODS
We retrospectively reviewed the records of patients who underwent robot-assisted bladder diverticulectomy by a single surgeon.


RESULTS
Between September 2008 and January 2011, 5 patients successfully underwent robot-assisted laparoscopic bladder diverticulectomy using 1% intravesical methylene blue. All cases were completed without intraoperative complication or need for open conversion. Mean operative time was 216 minutes, with a mean estimated blood loss of 45 mL. Patients were discharged 1-2 days following surgery. No patient experienced a perioperative complication.


CONCLUSIONS
The robot-assisted approach for bladder diverticulectomy is a viable alternative to both open and laparoscopic surgery. The use of intravesical methylene blue greatly aids in identification of the diverticular neck during this procedure.
Division of Endourology, Department of Urology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Charles R
CR
Moore
Samir P
SP
Shirodkar
Michael A
MA
Avallone
Scott M
SM
Castle
Michael A
MA
Gorin
Vladislav
V
Gorbatiy
Raymond J
RJ
Leveillee
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D004240:Diverticulum / Q000601:surgery*; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000008:administration & dosage*; D010535:Laparoscopy; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage*; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*
D007202:Indicators and Reagents; D008751:Methylene Blue