Male Robot-Assisted Radical Cystectomy

Abstract

The standard treatment of muscle invasive bladder cancer is open radical cystectomy (ORC) and urinary diversion. Radical cystectomy can be a challenging operation with significant patient morbidity and mortality. The urologic community has embraced laparoscopy to help decrease operative morbidity, which has been clearly seen by the widespread use of laparoscopic radical and donor nephrectomy. The first laparoscopic simple cystectomy was reported in 1992 by Parra et al. [1]. Since that publication, there have been several reports of laparoscopic radical cystectomy for malignant disease with various methods of urinary diversion. With the introduction of the daVinci® surgical system (Intuitive Surgical, Sunnyvale, CA), the prevalence of robot-assisted radical prostatectomies has seen a sharp increase, as this tool has helped surgeons overcome some of the technical challenges of pure laparoscopic pelvic surgery. It was a natural progression to apply robotic technology to laparoscopic cystectomies. In 2003, Menon et al. published the first series of robot-assisted radical cystectomy (RARC) and urinary diversion [2]. The goal of this chapter is to provide a detailed description of RARC in male patients as well as discuss pertinent literature on outcomes of this procedure.