Current Status and Outcomes of Robot-Assisted Laparoscopic Radical Cystectomy and Urinary Diversion

Richards, Kyle A.; Hemal, Ashok K.

doi:10.1007/s11934-010-0162-0

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…We have previously described our technique for RARC with or without ePLND and continue to perform it in a similar manner [14] , [15] . After fully dissecting and freely mobilizing the bladder and prostate, attention is turned to the urinary diversion.…”

Section: Operative Techniquementioning

confidence: 99%

Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

Sandberg

Hemal

2016

Asian Journal of Urology

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Robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC-ICUD) has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncologic control while benefiting from minimally invasive surgical techniques. Inspired by earlier open and laparoscopic work, initial descriptions of RARC-ICUD were published in 2003, and have since been followed by multiple larger case series which have suggested promising outcomes for our patients. However, the rate of adoption has remained relatively slow when compared to other robot-assisted procedures such as the radical prostatectomy, likely owing to longer operative times, operative complexity, costs, and uncertainty regarding oncologic efficacy. The operative technique for RARC-ICUD has evolved over the past decade and several high-volume centers have shared tips to improve efficiency and make the operation possible for a growing number of urologists. Though there are still questions regarding economic costs, effectiveness, and generalizability of outcomes reported in published data, a growing dataset has brought us ever closer to the answers. Here, we present our current operative technique for RARC-ICUD and discuss the state of the literature so that the urologist may hold an informed discussion with his or her patients.

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Section: Operative Techniquementioning

confidence: 99%

Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

Sandberg

Hemal

2016

Asian Journal of Urology

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Principles of Bladder Cancer Surgery

Anderson

Cookson

Chang

2013

Robotic Surgery of the Bladder

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Tissue-engineered conduit using bladder acellular matrix and bladder epithelial cells for urinary diversion in rabbits

LIAO,

SONG,

et al. 2013

Chinese Medical Journal

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Background For muscle invasive bladder cancer, radical cystectomy is the most effective treatment now and urinary diversion is often necessary. The use of intestinal tissue for urinary diversion is frequently associated with complications. In this study, we aimed to make a tissue-engineered conduit (TEC) using bladder epithelial cells and bladder acellular matrix (BAM) for urinary diversion in rabbits. Methods Bladder epithelial cells of rabbit were cultivated and expanded in vitro, then seeded on BAM, and cultured for 7 days. Then cell-seeded graft was used to make TEC. In the experimental group, most of bladder of the rabbit was removed while bladder trigone was retained. The proximal end of TEC was anastomosed with bladder trigone and the distal end was anastomosed with the abdominal stoma. In the control group, TEC was made using unseeded BAM. Haematoxylin and eosin staining was conducted, respectively, at 1, 2, 4, and 8 weeks postoperatively. Immunohistochemistry was performed 8 weeks postoperatively. Intravenous urography, retrograde pyelography, and cystoscopy of TEC were made at 12 weeks postoperatively. Results All animals were alive in the experimental group. Haematoxylin and eosin staining showed epithelial coverage in TEC. Immunohistochemistry showed anti-cytokeratin AE1/AE3 antibody and anti-ZO1 antibody positive, confirming there were mature and functional epithelial cells on the lumen of TEC. Retrograde pyelography and intravenous urography showed that TEC developed well and that there was no obstruction. In the control group, four rabbits were dead within 2 weeks and scar formation, atresia, and severe hydronephrosis were found. Conclusions We successfully made TEC using BAM and bladder epithelial cells for urinary diversion in rabbits. The lumen of this new TEC covered mature epithelial cells and could prevent urinary extravasation.

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Current Status and Outcomes of Robot-Assisted Laparoscopic Radical Cystectomy and Urinary Diversion

Cited by 3 publications

References 40 publications

Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

Principles of Bladder Cancer Surgery

Tissue-engineered conduit using bladder acellular matrix and bladder epithelial cells for urinary diversion in rabbits

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