Robotic-Assisted Laparoscopic Radical Cystectomy and Intra-Abdominal Formation of an Orthotopic Ileal Neobladder
Introduction
Laparoscopic surgery in conventional and especially robotic-assisted technique has expanded from simple ablative operations (e.g. nephrectomy) to more challenging ablative (e.g. radical prostatectomy) and even reconstructive (e.g. pyeloplasty) procedures. In case of tumor surgery, results of the laparoscopic approach equals that of open surgery [1]. Since the introduction of the robotic-assisted technique in urology in May 2000 this technique is preferred in our department [2]. Excellent three-dimensional (3D) vision (InSite Vision System™), physiological eye-hand coordination, extended grades of freedom (Endowrist™ technology) and a fast learning curve are the advantages of this system. Therefore, major surgical procedures can more easily be performed in a laparoscopic fashion. Here, we report the initial case of a laparoscopic robotic-assisted radical cystectomy and complete intra-abdominal formation of an orthotopic ileal neobladder for the treatment of transitional cell carcinoma of the bladder.
Section snippets
Patient and surgical technique
A 58-year-old white male with a 9-year history of bladder carcinoma and multiple transuretheral resections as well as intravesical instillation therapy was transferred to our department for radical cystectomy for invasive transitional cell carcinoma. After obtaining informed consent and standard mechanical bowel preparation, we performed the whole procedure in a laparoscopic robotic-assisted manner.
The procedure was performed using a DaVinci System (Intuitive Surgical, Mountain View, CA, USA).
Discussion
We here present the worldwide first case of an robotic-assisted laparoscopic cystectomy and formation of an orthotopic ileal neobladder where the complete procedure was performed intra-abdominally.
Turk et al. reported a case of a conventional laparoscopic cystectomy and insertion of the ureters in the sigmoid [3]. However, the formation of an orthotopic ileal neobladder has never been performed intra-abdominally via a robotic-assisted laparoscopic approach. Meng et al. just recently reported
References (4)
- et al.
Long-term followup after laparoscopic radical nephrectomy
J Urol
(2002) - et al.
Laparoscopic radical cystectomy with continent urinary diversion (rectal sigmoid pouch) performed completely intracorporeally: the initial 5 cases
J Urol
(2001)
Cited by (203)
The Studer Neobladder: An Established and Reproducible Technique for Intracorporeal Urinary Diversion
2022, European Urology Open ScienceA 25-year perspective on advances in an understanding of the biology, evaluation, treatment and future directions/challenges of urothelial cancer
2021, Urologic Oncology: Seminars and Original Investigations