V06-03 SURGICAL TECHNIQUE FOR SINGLE INCISION ROBOTIC RADICAL CYSTECTOMY WITH ORTHOTOPIC NEOBLADDER

Abstract

You have accessJournal of UrologyCME1 Apr 2023V06-03 SURGICAL TECHNIQUE FOR SINGLE INCISION ROBOTIC RADICAL CYSTECTOMY WITH ORTHOTOPIC NEOBLADDER Justin Campagna, Adri Durant, and Mark Tyson Justin CampagnaJustin Campagna More articles by this author , Adri DurantAdri Durant More articles by this author , and Mark TysonMark Tyson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003274.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic cystectomy is associated with low utilization rates of orthotopic neobladder reconstruction due to challenges related to intracorporeal sewing and configuration. A new technique that shortens the learning curve may lead to greater utilization of neobladders and improve outcomes. In this video, we present a new technique for single incision robotic cystectomy (SIRC) with orthotopic Studer-type ileal neobladder using the da Vinci Single Port (SP) robotic platform. METHODS: A single 5 cm periumbilical incision is utilized to perform a robotic cystectomy in standard fashion, preserving neurovascular bundles when indicated. The robot is undocked, the specimen is removed and the Studer neobladder is constructed extracorporeally through the 5 cm incision. Enterotomies are made for the urethral and ureteral anastomoses, with pre-placement of anastomotic sutures to facilitate intracorporeal anastomosis. The neobladder is returned to the abdomen, the robot is redocked and the anastomoses are completed intracorporeally. RESULTS: Forty-one patients have undergone SIRC, with 50% of these patients undergoing orthotopic neobladder reconstruction. Seventeen (41%) of all single-port cases were converted to open. The median operative time was 480 minutes and the median length of hospitalization was seven days. 17% required readmission to the hospital, 17% developed small bowel obstruction or ileus, and 13% required a blood transfusion. There were no differences noted in pain (morphine milligram equivalents) between the patients who underwent SIRC and those that were converted to open. CONCLUSIONS: SIRC with orthotopic neobladder reconstruction using the da Vinci Single Port (SP) robotic platform is a safe and feasible minimally invasive approach. With this hybrid intracorporeal/extracorporeal technique, incisional burden is limited to what would otherwise be required for extraction while simultaneously adhering to long-standing principles of neobladder reconstruction. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e509 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin Campagna More articles by this author Adri Durant More articles by this author Mark Tyson More articles by this author Expand All Advertisement PDF downloadLoading ...