Robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty

Abstract

Background. Radical cystectomy uses laparoscopic and robotic approaches along with the open ones. Objective: To study immediate results of robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty. Materials and methods. Robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty was performed in 15 patients (13 male, 2 female), aged 64-76 years. Fourteen patients had bladder cancer, 1 female - a postradiation bladder fistula and microcystis. T2 stage was detected in 8 (57.1 %) patients, T3 - in 6 (42.9 %). After the operation we evaluated operation time, blood loss volume, hospital stay, functional and oncological results. Results. Average operation time was 380 (320-560) minutes, blood loss volume - 80-200 ml, blood transfusion was not performed. Early complications (up to 30 days) were observed in 7 patients (46.7 %), late ones (90-days) - in 6 (40.0 %). There were no cases of intestinal obstruction. Patients with ureteral-intestinal (n = 2) and reservoir-urethral (n = 1) anastomosis failure underwent percutaneous renal drainage. One patient died of acute myocardial infarction. Daytime continence was 80.0 %, nocturnal - 53.3 %. One patient died of disease progression within 7.6 observation months. Conclusion. Robot-assisted radical cystectomy with intracorporeal urine diversion is a modern and minimally invasive method for patients with muscle-invasive bladder cancer. More experience in this field will allow to reduce surgery time and number of complications.