Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Totally Intracorporeal Ileal Neobladder

Sala, L; Matsunaga, Garrett S.; Corica, Federico A.; Ornstein, David K.

doi:10.1089/end.2006.20.233

Cited by 76 publications

(39 citation statements)

References 12 publications

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“…Most studies included used extracorporeal urinary diversion. Intracorporeal urinary diversion has been demonstrated to be technically feasible with good oncological outcomes (13,30). More data is needed to assess long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Fonseka

Ahmed

Froghi

et al. 2015

Arch Ital Urol Androl

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Objective: To conduct a systematic review and meta-analysis comparing outcomes between Open Radical Cystectomy (ORC), Laparoscopic Radical Cystectomy (LRC) and Robot-assisted Radical Cystectomy (RARC). RARC is to be compared to LRC and ORC and LRC compared to ORC. Material and methods: A systematic review of the literature was conducted, collating studies comparing RARC, LRC and ORC. Surgical and oncological outcome data were extracted and a meta-analysis was performed. Results: Twenty-four studies were selected with total of 2,104 cases analyzed. RARC had a longer operative time (OPT) compared to LRC with no statistical difference between length of stay (LOS) and estimated blood loss (EBL). RARC had a significantly shorter LOS, reduced EBL, lower complication rate and longer OPT compared to ORC. There were no significant differences regarding lymph node yield (LNY) and positive surgical margins (PSM.) LRC had a reduced EBL, shorter LOS and increased OPT compared to ORC. There was no significant difference regarding LNY. Conclusion: RARC is comparable to LRC with better surgical results than ORC. LRC has better surgical outcomes than ORC. With the unique technological features of the robotic surgical system and increasing trend of intra-corporeal reconstruction it is likely that RARC will become the surgical option of choice. SummaryNo conflict of interest declared. my (RARC) has since emerged as a viable alternative. RARC has been reported to be associated with fewer complications compared to LRC (2) and the appeal of the robotic surgical system has led to the adoption of the procedure worldwide. However the production of high-quality evidence that measures the relative merits of ORC, LRC and RARC is lacking with surgeons having to rely on systematic review. This article aims to compare surgical and oncological outcomes of ORC, LRC and RARC. METHODS Eligibility criteriaData were collected on all patients over the age of 60 with muscle-invasive bladder cancer undergoing RARC, LRC or ORC. Surgical outcomes were; operative time (OPT), estimated blood loss (EBL), length of stay (LOS) and complication rate 90 days post-operatively. Oncological outcomes were; lymph node yield (LNY) and positive surgical margins (PSM). Comparisons were made between RARC, LRC and ORC and the outcomes of interest measured included both surgical and oncological outcomes. The studies forming the current meta-analysis include comparative studies, either retrospective or prospective, as well as randomized control trials. For a study to be included in our analysis it had to fulfill the following criteria. The study had to: -Compare outcome measures of two or all three surgical techniques (ORC, LRC and RARC). -Use quantitative data for at least one outcome measure.-Be a high quality study.If it was one of two studies that were produced by the same institution, it was ensured the data were mutually exclusive. Studies were excluded if they: -Lacked reporting of the desired outcome measures listed above or presented the data in such a way that...

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Section: Discussionmentioning

confidence: 99%

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Fonseka

Ahmed

Froghi

et al. 2015

Arch Ital Urol Androl

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“…3 Several studies have now validated the feasibility of RACIC, but the advantages over standard open cystectomy remain to be proven. 13,21,22 In comparing RACIC with LACIC, there seems to be a clear advantage for RACIC with regard to complications (Table 3): there were significantly fewer intraoperative and postoperative complications in the RACIC group (Table 4). In patients in the RACIC group, there was only one (7%) intraoperative complication (obturator nerve injury) compared with 3 (15%) in patients in the LACIC group.…”

Section: Discussionmentioning

confidence: 99%

“…13 Port placement is shown in Figure 1. When creating the ileal conduit, the left ureter was brought under the sigmoid mesentery, and the terminal ileum was tagged with a silk suture before a 5 to 7 cm midline periumbilical incision was made.…”

Section: Racic Operative Techniquementioning

confidence: 99%

Comparative Analysis of Laparoscopic and Robot-Assisted Radical Cystectomy with Ileal Conduit Urinary Diversion

Abraham

Young

Box

et al. 2007

Journal of Endourology

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“…Sala and colleagues [13] reported total operative time for RARC with intracorporeal ileal orthotopic neobladder creation of 12 h; however, more recently, Pruthi and coworkers [10] have reported more acceptable average operative duration for intracorporeal urinary diversion of 5.3 h with mean EBL of 221 mL and mean hospital stay of 4.5 days. Likely, surgeon experience is the most critical factor defining operative times, and total intracorporeal urinary diversion may be a reasonable option to consider in select patients with an experienced team.…”

Section: Robot-assisted Radical Cystectomy In Femalesmentioning

confidence: 99%

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

Richards

Hemal

2011

Curr Urol Rep

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Robot-assisted laparoscopic radical cystectomy (RARC) has emerged as a viable treatment option for patients with muscle-invasive bladder cancer and select patients with high-risk nonmuscle invasive disease. Operative, perioperative, and intermediate-term oncologic outcomes for RARC from multiple single-institution reports and from multi-institutional studies appear promising. Long-term oncologic outcomes for RARC should be forthcoming in the years ahead. As technology improves, total intracorporeal urinary diversion may become easier to perform and less time-consuming. This article aims to review the most recent developments within the past 1 to 2 years surrounding RARC, important technical nuances for performing this operation, and the future direction of RARC.

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Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Totally Intracorporeal Ileal Neobladder

Abstract: Robot-assisted laparoscopic radical cystoprostatectomy with intracorporeal ileal neobladder construction is technically feasible. However, its role in the management of invasive bladder cancer remains to be defined.

Cited by 76 publications

References 12 publications

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Comparing robotic, laparoscopic and open cystectomy: a systematic review and meta-analysis

Comparative Analysis of Laparoscopic and Robot-Assisted Radical Cystectomy with Ileal Conduit Urinary Diversion

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

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