Robotic Intracorporeal Continent Cutaneous Diversion.
Robotic intracorporeal urinary diversion has mostly been done for ileal conduit or orthotopic neobladder diversion. We present what is to our knowledge the initial series, detailed technique and outcomes of the robotic intracorporeal Indiana pouch with a minimum 1-year followup.



Ten patients underwent robotic radical cystectomy, pelvic lymphadenectomy and intracorporeal Indiana pouch urinary diversion for cancer in 9 and benign disease in 1. Data were collected prospectively. Baseline demographics, pathology data, and 1-year complication rates and functional outcomes were assessed.



All 10 cases were successfully completed intracorporeally without open conversion. Median total operative time was 6 hours, including 3.5 hours for pouch creation. Median blood loss was 200 cc and median hospital stay was 10 days. Four Clavien grade 1-2 and 3 Clavien 3-5 complications occurred. None of the patients had a bowel leak. One noncompliant patient requested undiversion to an ileal conduit. The remaining 9 patients successfully catheterized the ileal channel and were completely continent at the last followup at a median of 13.7 months (range 12.3 to 15.2). Study limitations include small sample size and short followup.



We present what is to our knowledge the initial series of robotic completely intracorporeal Indiana pouch diversion. Early perioperative data indicate acceptable operative efficiency and complication rates. Longer followup is required to assess the functional outcomes of this less commonly performed diversion.
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy. Electronic address: mihir.desai@med.usc.edu.
Mihir M
MM
Desai
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Giuseppe
G
Simone
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Andre Luis
AL
de Castro Abreu
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Sameer
S
Chopra
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Mariaconsiglia
M
Ferriero
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Salvatore
S
Guaglianone
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Francesco
F
Minisola
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Daniel
D
Park
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Rene
R
Sotelo
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Michele
M
Gallucci
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Inderbir S
IS
Gill
Section of Robotic Surgery, University of Southern California Institute of Urology, Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California; Department of Urology, Regina Elena National Cancer Institute (GS, MF, SG, FM, MG), Rome, Italy.
Monish
M
Aron
D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*
continent; postoperative complications; robotics; treatment outcome; urinary diversion; urinary reservoirs