Minimally invasive radical cystectomy and its role and future in treatment of bladder cancer patients myth or reality?

Abstract

Despite the improvements in surgical technique, open radical cystectomy (ORC) is still associated with significant early and late complications rates even when performed in referral centres by experienced surgeons. Therefore, numerous centres across the world have incorporated a minimally invasive approach such as laparoscopic (LRC) and robotic radical cystectomy (RRC) as a viable alternative for selected patients. LRC showed to be feasible and to provide better intraoperative outcomes such as less blood loss at the cost of higher operative times. One of the major concerns regards its steep learning curve. On the other hand, RRC showed to be able to reduce this learning curve and to lead to better intra- and post-operative outcomes. However, these data are mainly based on retrospective series and should be interpreted with caution. Moreover, long-term oncological outcomes of patients treated either with LRC or RRC are still unknown and awaited.