title: Robot-assisted radical cystectomy and urinary diversion: technical recommendations from the Pasadena Consensus Panel.
abstract: BACKGROUND
  The technique of robot-assisted radical cystectomy (RARC) has evolved significantly since its inception >10 yr ago. Several high-volume centers have reported standardized techniques with refinements and subsequent outcomes.
  
  
  OBJECTIVE
  To review all existing literature on RARC and urinary diversion techniques and summarize key points that may affect oncologic, surgical, and functional outcomes.
  
  
  METHODS
  The Pasadena Consensus Panel on RARC and urinary reconstruction convened May 3-4, 2014, to review the existing peer-reviewed literature and create recommendations for best practice. The panel consisted of experts in open radical cystectomy and RARC. No commercial support was received.
  
  
  METHODS
  The consensus panel extensively reviewed the surgical technique of RARC in men and women, extended pelvic lymph node dissection, extracorporeal urinary diversion, and intracorporeal urinary diversion. Critical aspects of the technique are described.
  
  
  METHODS
  Preoperative, operative, and postoperative parameters from the largest and most contemporary RARC series, stratified by urinary diversion technique, are presented.
  
  
  CONCLUSIONS
  Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery.
  
  
  CONCLUSIONS
  Refinement of techniques for RARC and urinary diversion over the past 10 yr has made it safe, reproducible, and oncologically sound.
  
  
  RESULTS
  We summarize the critical aspects of surgical techniques reviewed at the Pasadena international consensus meeting on RARC and urinary reconstruction. Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery.
authors.affiliation: City of Hope Cancer Center, Duarte, CA, USA. Electronic address: kchan@coh.org.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Chan
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Guru
authors.affiliation: Karolinska Institute, Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Wiklund
authors.affiliation: University of Sheffield, Sheffield, UK.
authors.forename: James
authors.initials: J
authors.lastname: Catto
authors.affiliation: City of Hope Cancer Center, Duarte, CA, USA.
authors.forename: Bertram
authors.initials: B
authors.lastname: Yuh
authors.affiliation: University of Padua, Padua, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.affiliation: Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Declan G
authors.initials: DG
authors.lastname: Murphy
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Tareq
authors.initials: T
authors.lastname: Al-Tartir
authors.affiliation: Karolinska Institute, Stockholm, Sweden.
authors.forename: Justin W
authors.initials: JW
authors.lastname: Collins
authors.affiliation: City of Hope Cancer Center, Duarte, CA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Zhumkhawala
authors.affiliation: City of Hope Cancer Center, Duarte, CA, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Wilson
mesh_terms: D032921:Consensus; D015653:Cystectomy / Q000009:adverse effects / Q000592:standards*; D055317:Evidence-Based Practice / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000592:standards*; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000592:standards*
keywords: Bladder cancer; Cystectomy; Extended pelvic lymph node dissection; Extracorporeal urinary reconstruction; Ileal conduit urinary diversion; Indiana pouch; Intracorporeal urinary reconstruction; Orthotopic urinary diversion; Radical cystectomy; Robot-assisted radical cystectomy