A Comparative study of Robot-Assisted Laparoscopic Intracorporeal Versus Open Urinary Diversion

Abstract

R obot-assisted radical cystectomy has been performed for patients with muscle-invasive and high-risk superficial bladder cancers at a number of centers with robotic technology. Recent studies have reported no significant differences in the oncologic efficacy following either RARC or ORC. With increasing expertise, RARC is likely to become the minimally invasive technique of choice for patients seeking radical cystectomy. Historically, following completion of RARC, an ECUD was preferred because of the complexity of the procedure. With the evolution of robotic surgery, its three dimensional vision and improved ergonomics (EndoWrist technology); intracorporeal suturing becomes much easier. This situation added a new dimension to reconstructive surgery, enabling the surgeon to perform both continent and incontinent urinary diversions intracorporeally. Intracorporeal urinary diversion had gained popularity as a viable alternative to ECUD, with the potential benefits of a smaller incision, reduced pain, decreased bowel exposure and reduced risk of fluid imbalances. At present, however, there are a limited number of studies evaluating the outcomes of ICUD compared with ECUD. This article aimed to compare perioperative outcomes and complications of ICUD and ECUD following cystectomy from our institution cohort through patients’ chart review.