Robot‐assisted approach to ‘W’‐configuration urinary diversion: a step‐by‐step technique

Hussein, Ahmed A.; Ahmed, Youssef; Kozlowski, Justen; May, Paul; Nyquist, John; Sexton, Sandra; Curtin, Leslie; Peabody, James O.; Abol‐Enein, Hassan

doi:10.1111/bju.13824

Cited by 48 publications

(38 citation statements)

References 12 publications

(12 reference statements)

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“…In this study, grade 3 Clavien‐Dindo complications occurred in the ICNB group, and none of the patients died within 90 days after surgery. However, the complication rates were similar to those reported in large open or RARC series …”

Section: Discussionsupporting

confidence: 87%

“…In addition, 23 patients (2.3%) died within 90 days after surgery . In an analysis based on the IRCC database, the major complication rate was 20% in RARC patients with intracorporeal urinary diversion, whereas 32% was reported for extracorporeal urinary diversion . In this study, grade 3 Clavien‐Dindo complications occurred in the ICNB group, and none of the patients died within 90 days after surgery.…”

Section: Discussionmentioning

confidence: 55%

“…In fact, ICNB is challenging for the urologist compared with ECNB owing to technical difficulties with the reconfiguration of the ileum and prolonged operative time. Therefore, the adoption of ICNB has been slow and is confined to high‐volume academic institutions worldwide . An analysis of 18 centers contributing to the IRCC registry showed that 935 patients underwent RARC between 2003 and 2011.…”

Section: Discussionmentioning

confidence: 99%

“…To date, the adoption of ICNB has been confined to high‐volume academic institutions worldwide. However, several techniques for ICNB have been reported with promising functional outcomes …”

Section: Introductionmentioning

confidence: 99%

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Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes

Koie

Οhyama

Yoneyama

et al. 2018

Int J Med Robotics Comput Assist Surg

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BackgroundThis study compared the surgical and urinary functional outcomes in patients with muscle‐invasive bladder cancer (MIBC) who underwent robot‐assisted radical cystectomy (RARC) followed by intracorporeal ileal neobladder reconstruction (ICNB) to those in patients who underwent minimum incision endoscopic radical cystectomy (MIE‐RC) followed by extracorporeal ileal neobladder reconstruction (ECNB).Materials and MethodsThis study reviewed the clinical records of 153 consecutive MIBC patients who underwent neoadjuvant chemotherapy followed by radical cystectomy and ileal neobladder reconstruction.ResultsThe operative time in the ICNB group was significantly longer than that in the ECNB group. The median estimated blood loss was significantly less in the ICNB group than in the ECNB group. The neobladder capacity gradually increased in both groups. The maximum neobladder pressure and urethral closure pressure gradually improved in both groups.ConclusionOur initial experience with ICNB was favourable, with acceptable surgical and urinary functional outcomes.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes

Koie

Οhyama

Yoneyama

et al. 2018

Int J Med Robotics Comput Assist Surg

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“…However, ICUD might have potential benefits, including decreased fluid loss, reduced EBL and a quicker return of bowel function . The adoption of ICNB has hitherto been limited to high‐volume academic institutions, and several surgical techniques for ICNB have been reported with promising functional outcomes …”

Section: Introductionmentioning

confidence: 99%

Utility of robot‐assisted radical cystectomy with intracorporeal urinary diversion for muscle‐invasive bladder cancer

et al. 2019

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Radical cystectomy remains the gold standard for treatment of muscle‐invasive bladder cancer. Robot‐assisted radical cystectomy has technical advantages over laparoscopic radical cystectomy and has emerged as an alternative to open radical cystectomy. Despite the advancements in robotic surgery, experience with total intracorporeal reconstruction of urinary diversion remains limited. Most surgeons have carried out the hybrid approach of robot‐assisted radical cystectomy and extracorporeal reconstruction of urinary diversion, as intracorporeal reconstruction of urinary diversion remains technically challenging. However, intracorporeal reconstruction of urinary diversion might potentially proffer additional benefits, such as decreased fluid loss, reduction in estimated blood loss and a quicker return of bowel function. The adoption of intracorporeal ileal neobladder reconstruction has hitherto been limited to high‐volume academic institutions. In the present review, we compare the totally intracorporeal robot‐assisted radical cystectomy approach with open radical cystectomy and robot‐assisted radical cystectomy + extracorporeal reconstruction of urinary diversion in muscle‐invasive bladder cancer patients.

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Robot‐assisted versus open radical cystectomy: A cohort study on perioperative outcomes accounting for stage selection bias and surgical experience

Zeuschner

Linxweiler

Mohr

et al. 2021

Robotics Computer Surgery

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Background Most comparisons of robot‐assisted (RARC) versus open radical cystectomy (ORC) for urothelial carcinoma do not factor the inherent stage selection bias or surgical experience. Methods We compared the perioperative outcomes of 229 RARC and 335 ORC at a single tertiary referral centre with propensity score matching and multiple regression models, when controlling for tumour and patient characteristics, surgeon's experience and type of urinary diversion. Results RARC had less major complications (19.8% vs. 34.1%) and ICU admissions (6.6% vs. 19.8%), with lower blood loss (400 vs. 500 ml) and transfusion rates. The operating time was longer (336 vs. 286 min), but decreased with surgeon's experience. RARC had less positive surgical margins (3% vs. 8.4%) and a higher lymph node count (14 vs. 11). Conclusions In this large single centre series comparing RARC with ORC controlling for stage selection bias and surgical experience, RARC proved significantly better outcomes, especially with intracorporeal urinary diversion.

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Robot‐assisted approach to ‘W’‐configuration urinary diversion: a step‐by‐step technique

Abstract: We described our step-by-step technique and initial perioperative outcomes of our first five ICNBs with 'W' configuration.

Cited by 48 publications

References 12 publications

Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes

Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes

Utility of robot‐assisted radical cystectomy with intracorporeal urinary diversion for muscle‐invasive bladder cancer

Robot‐assisted versus open radical cystectomy: A cohort study on perioperative outcomes accounting for stage selection bias and surgical experience

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