Robot assisted laparoscopic cystoprostatectomy with ultrapreservation and intracorporeal neobladder
Year: 2025
Type: article
Study design: Case Report
Abstract: Objective Radical cystectomy remains the gold standard for muscle invasive bladder cancer. Though described many years ago, laparoscopic robot assisted approach remains controversial due to its steep learning curve and long operative time, despite the proven benefits of minimally invasive surgery. We describe our totally intracorporeal approach for bladder cancer. Patient and surgical outcome We present the case of a 59-year old male with high-grade muscle invasive bladder cancer who underwent a minimally invasive technique. We ruled out a coexisting prostate cancer. After identification and isolation of both ureters, followed by an extended pelvic lymphadenectomy, posterior dissection begins, where neurovascular bundle preservation starts. Anterior dissection spares the endopelvic fascia and dorsal venous complex. After completion of the cystectomy, ileo-urethral anastomosis is performed. By isolating 40cm of small bowel we constructed the neobladder in ‘Bordeaux’s’ technique. Check for leakage with 60mL of saline and any extra suturing is made before finishing. A 19Fr drainage catheter is placed in the small pelvis. Results Mean surgery time was 420 minutes and the estimated blood loss was 300mL. Patient was discharged at postoperative day 6 without any perioperative complications. Ureteral stents were removed in outpatient care 14 days later and urethral Foley catheter 7 days after. Six month follow-up proves full restoration of urinary continence and no major (Clavien >2) postoperative complications. Conclusions Minimally invasive with totally intracorporeal approach after radical cystectomy is feasible and effective in terms of urinary continence and oncological outcomes.
Source: Urology Video Journal
Authors: wenceslao villamil, Agustin Romeo, Felipe Gentile, Gabriel Favre, Andres Alfieri, Matias Gonzalez
Institution: Hospital Italiano de Buenos Aires
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $800
OpenAlex ID: W4413996742