Update on robotic cystectomy

Abstract

Purpose of reviewThis article aims to discuss recently published (2019–2021) studies on robot-assisted radical cystectomy (RARC) with attention to evidence comparing intracorporeal (ICUD) and extracorporeal urinary diversion (ECUD) in terms of intraoperative and perioperative metrics.Recent findingsRARC produces equivalent oncological outcomes compared to open radical cystectomy (ORC). The benefits of RARC are most pronounced perioperatively. ICUD has been increasingly used at centers of excellence as it reduces intestinal exposure, which may incrementally minimize morbidity compared to ECUD or ORC. As the learning curve for ICUD diversion has flattened, retrospective analyses have emerged that suggest this technique may hold benefit over both ORC and RARC with ECUD, though current data is conflicting, and a randomized controlled study is forthcoming.SummaryORC is the current ‘gold standard’ management for muscle-invasive bladder cancer. Based on the premise of the minimization of perioperative morbidity, the development of RARC, most recently with ICUD, seeks to improve patient outcomes. Despite a protracted learning curve, many expert bladder cancer centers have adopted an intracorporeal approach. As more centers adopt, refine, and climb the learning curve for ICUD, a clearer insight of its effect on morbidity will be revealed—informing further adoption of the technique.

Cistectomia Radical Robótica No Tratamento De Câncer De Bexiga: Revisão Integrativa

“…Portanto, a cistectomia radical assistida por robô surgiu como uma alternativa melhor à cistectomia radical aberta devido à sua possível redução na perda de sangue estimada, taxa de transfusão de sangue e analgesia pósoperatória e recuperação mais rápida da função intestinal. (7,8) Nesta revisão, discutimos o conhecimento atual da cistectomia assistida por robô, comparando a abordagem robótica com a técnica aberta convencional.…”