Radical cystectomy: from open to laparoscopic to robotic surgery

Abstract

In recent years, the techniques of radical cystectomy and urinary diversion are continually improving , the surgical safety and efficacy are continually increasing. From open to laparoscopic to robotic, surgical techniques are progressing, but it is not yet possible to replace each other. With the development of equipment, laparoscopic radical cystectomy(LRC) and robotic-assisted laparoscopic radical cystectomy (RARC)can further improve the perioperative efficacy, the basic principles of open surgery can be copied, their perioperative oncologic outcomes are not inferior to open surgery. RALRC seems to have more advantages in pelvic lymph node dissection, long-term oncologic outcomes of the three techniques are similar, and open surgery seems to have more advantages in advanced tumors. Intracorporeal construction of the urinary diversion is still the mainstream, extracorporeal is likely to be the future direction. Laparoscopy is still the most suitable minimally invasive technique of radical cystectomy according to our national conditions. Key words: Radical cystectomy(RC); Open radical cystectomy(ORC); Laparoscopy radical cystectomy(LRC); Robotic-assisted laparoscopic radical cystectomy(RARC)