The Learning Curve of Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

Hayn, Matthew H.; Hussain, Abid; Mansour, Ahmed M.; Andrews, Paul; Carpentier, Paul; Castle, Erik P.; Dasgupta, Prokar; Rimington, Peter; Thomas, Raju; Khan, Shamim; Kibel, Adam S.; Kim, Hyung L.; Manoharan, Murugesan; Menon, Mani; Mottrie, Alexandre; Ornstein, David K.; Peabody, James O.; Pruthi, Raj S.; Redorta, Joan Palou; Richstone, Lee; Schanne, Francis; Stricker, Hans; Wiklund, Peter; Chandrasekhar, Rameela; Wilding, Greg; Guru, Khurshid A.

doi:10.1016/j.eururo.2010.04.024

Cited by 216 publications

(140 citation statements)

References 27 publications

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“…Generally our low rate of complications was at an acceptable level, and also comparable to that of our series. [17][18][19][20] In one patient neobladder rupture (Clavien grade 4) developed on postoperative 25. day. The patient was explored, and any problem in the perfusion or blood supply of the neobladder was not observed.…”

Section: Discussionmentioning

confidence: 99%

“…As reported by Hayn et al [17] 21 patients should be operated to achieve an operative time of 6.5 hours, and 30 patients should be operated to complete a learning curve for 20 lymphadenectomies, and in this study extracorporeal urinary diversions were performed. In a series of 132 patients who had undergone intracorporeal diversion an average operative time of 7.6 hours was reported.…”

Section: Discussionmentioning

confidence: 99%

“…As reported in the literature, as the number of operated cases increases, RRC's can be performed for more bulky tumors with clinical stage T3 without compromising favourable oncological outcomes. [17] Pelvic lymphadenectomy which is an important component of RCC can be easily accomplished using robot-assisted technique. Lymph node positivity detected in our 5 patients may indicate superiority of robotic surgery related to this issue.…”

Section: Discussionmentioning

confidence: 99%

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Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

İslamoğlu

Anıl

Erol

et al. 2018

Turkish Journal of Urology

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Objective: To present the surgical and pathological results of robotic radical cystectomy (RRC) operations performed in our clinic. Material and methods:A total of 18 patients, who underwent RRC and intracorporeal urinary diversion between October 2016 and September 2017 for clinically localized bladder cancer in our clinic, were included in the study. The results were evaluated under three headings. 1. operative outcomes (total operation time, perioperative blood loss, postoperative hematocrit decrease) 2. recovery period (pull-off drain day, hospitalization time) 3. oncological results (pathologic stage, surgical margin, number, and characteristics of lymph nodes removed). Complications within the postoperative 30-day period, were evaluated and the Clavien classification system was used to classify the complications. Results:The mean age of the patients was 64.4 (52-80) years. Seventeen male patients and one female patient underwent robotic cystectomy. At the operative outcomes, the mean blood loss was 325 mL, and the mean hematocrit decrease was 3.15%. The mean duration of the surgery was 471 minutes (330-630), while the median operative time was 450 minutes. Complications occured in 6 patients during the early postoperative period. Six of them (75%) had minor complications (Clavien grade 1), two patients (25%) had major complications (Clavien grade 4). Conclusion:Our initial experience with RRC is that, this surgical technique has acceptable operative, oncological and short-term clinical outcomes. However, prospective randomized studies are needed to assess whether there is a clear advantage compared to open surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

İslamoğlu

Anıl

Erol

et al. 2018

Turkish Journal of Urology

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“…Analysis of IRCC data has demonstrated a mean lymph node yield of 19. Subsequent analyses found that high-volume centers (<100 cases) have the highest yields and high-surgeon volume (>50 cases) independently predicted the technique of lymphadenectomy (extended rather than standard) [5]. Another study employed one surgeon to perform lymph node dissection and an experienced open surgeon to conduct a second look open lymphadenectomy.…”

Section: Lymph Node Dissection and Yieldmentioning

confidence: 99%

“…Large series with long term follow-up in ORC have shown that approximately half of all cystectomy patients experience local recurrence or distant metastatic disease with subsequent mortality [3]. Surgeons should choose their patients early in their RARC learning curve due to concerns for oncologic control and the technically difficult nature of RARC [4,5].…”

Section: Introductionmentioning

confidence: 99%

Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Rao

Stegemann

Rehman

et al. 2012

Indian J Surg Oncol

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Robot-assisted radical cystectomy (RARC) for bladder cancer is increasingly becoming popular in specialist centres around the world. RARC has the advantage of being minimally invasive and also the dexterity of the instruments allow reconstruction such as ileal conduit urinary diversion or neobladder formation. Starting from the initial series demonstrating the feasibility of RARC and extended pelvic lymph node dissection, we now have mature series demonstrating equal oncological and functional outcomes in the medium term follow-up. In addition, literature suggests decreased hospital stay, less blood loss equating to less blood transfusion and a trend towards decreased complications as well. In the near future we would anticipate further refinement and reduced operating times with increased benefits for the patient undergoing RARC.

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Robotic versus open radical cystectomy for bladder cancer in adults

Aboumarzouk

Bondad

Ahmed

et al. 2015

Cochrane Database of Systematic Reviews

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Analysis 1.4. Comparison 1 Robotic-assisted laparoscopic versus open radical cystectomy, Outcome 4 Transfusion rate. Analysis 1.5. Comparison 1 Robotic-assisted laparoscopic versus open radical cystectomy, Outcome 5 Hospital stay.. Analysis 1.6. Comparison 1 Robotic-assisted laparoscopic versus open radical cystectomy, Outcome 6 Quality of life. Analysis 1.7. Comparison 1 Robotic-assisted laparoscopic versus open radical cystectomy, Outcome 7 Positive margin.

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The Learning Curve of Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

Cited by 216 publications

References 27 publications

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Robotic versus open radical cystectomy for bladder cancer in adults

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