title: Robotic Anterior Pelvic Exenteration for Bladder Cancer in Patient With Previous Kidney-Pancreas Transplantation.
abstract: BACKGROUND
  To demonstrate the feasibility of robotic anterior pelvic exenteration with intracoporeal ileal conduit for bladder cancer in a patient with previous kidney-pancreas transplantation.
  
  
  METHODS
  Technical considerations included avoiding injury to transplant graft, minimizing devascularization of transplant ureter, intracorporeal mobilization of bowel with pancreas graft, and positioning of ileal conduit. Surgical approach required multidisciplinary approach for surgical planning and medical management.
  
  
  CONCLUSIONS
  The patient's preoperative serum creatinine was 1.22 ng/mL and was unchanged at 1.21 ng/mL 1 month following surgery. Total robotic console time was 4 hours and 21 minutes and estimated blood loss is 30 cc. There were no intraoperative complications. Final pathology demonstrated pT1N0 high-grade multifocal micropappilary urothelial cell carcinoma with carcinoma in situ, and all surgical margins were negative. Robotic anterior pelvic exenteration with intracorporeal urinary diversion for bladder cancer in patient with previous kidney-pancreas transplantation is a challenging but a feasible surgical technique that requires a multidisciplinary team and a low threshold to convert to open surgery.
authors.affiliation: Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Nyame
authors.affiliation: Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Naveen
authors.initials: N
authors.lastname: Nandanan
authors.affiliation: Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Greene
authors.affiliation: Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Krishnamurthi
authors.affiliation: Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: haberg2@ccf.org.
authors.forename: Georges-Pascal
authors.initials: GP
authors.lastname: Haber
mesh_terms: D015653:Cystectomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D016030:Kidney Transplantation; D008875:Middle Aged; D016035:Pancreas Transplantation; D010385:Pelvic Exenteration / Q000379:methods*; D065287:Robotic Surgical Procedures; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion