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Robotic cystectomy

A Kanashiro, J M Gaya, J Palou, L Gausa, H Villavicencio
OBJECTIVES: To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. MATERIALS AND METHODS: From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases...
October 18, 2016: Actas Urologicas Españolas
Nobuyuki Hinata, Ahmed Aly Hussein, Saby George, Donald L Trump, Ellis G Levine, Kawa Omar, Prokar Dasgupta, Muhammad Shamim Khan, Abolfazl Hosseini, Peter Wiklund, Khurshid A Guru
OBJECTIVES: To evaluate the effect of suboptimal dosing on the outcomes of patients who received neoadjuvant chemotherapy (NAC) and robot-assisted radical cystectomy (RARC). PATIENTS AND METHODS: We retrospectively reviewed 336 consecutive patients with urothelial carcinoma of the bladder who were treated with NAC and RARC at three academic institutions. Outcomes were compared between 3 groups: patients who received optimal NAC; patients who received suboptimal NAC; and those who did not receive NAC...
October 15, 2016: BJU International
Xixue Zhang, Jionglin Wei, Xiaoxing Song, Yuhao Zhang, Weiqing Qian, Lu Sheng, Zhoujun Shen, Lvjun Yang, Rong Dong, Weidong Gu
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy and robot-assisted radical cystectomy have gradually become the preferred choices for urologists as they allow surgeons to perform complex procedures more precisely and effectively. The pneumoperitoneum, which is normally applied in these surgeries to provide visual clarity and space to perform the procedure, may cause hemodynamic disturbance, potentially myocardial injury. Thus surgeons have recently considered opting for the low-pressure pneumoperitoneum to lower this negative impact...
October 10, 2016: Trials
Pratik Man Singh Gurung
No abstract text is available yet for this article.
October 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
F Algreisi, G Vilos, A Oraif, A Vilos, S Pautler
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Zhiyuan Shen, Zhongquan Sun
BACKGROUND: With the introduction of robotic surgery, whether the robot-assisted radical cystectomy (RARC) could reduce the perioperative morbidity compared with Open radical cystectomy (ORC) was unknown. METHODS: Studies reported RARC were reviewed based on all randomized controlled trials (RCTs), which focused on the efficacy of RARC versus ORC. RESULTS: Of the 201 studies from preliminary screening, four RCTs were included. By pooling these studies, there were significant differences in comparison of operative time (p = 0...
2016: BMC Urology
Danny Huynh, Alex Henderson, Tyler Haden, Alexander Jones, Naveen Pokala
Robot-assisted laparoscopic radical cystectomy (RALRC) is increasingly being performed for the treatment of muscle-invasive bladder cancer. There is increased tension while performing the ureteroileal anastomosis through a small incision. Patients are at risk to suffer wound and skin complications perioperatively due to possible contamination with bowel contents. The Alexis(®) retractor helps with retraction of small incisions potentially reducing tension and also reduces wound infection rates as reported in the colorectal literature...
September 17, 2016: Journal of Robotic Surgery
Q Alimi, B Peyronnet, S-F Kammerer-Jacquet, M Lefevre, B Gires, R Mathieu, L Tondut, S Vincendeau, A Manunta, N Rioux-Leclercq, F Guille, K Bensalah, G Verhoest
INTRODUCTION: The aim of this study was to report perioperative and oncological outcomes of robot-assisted radical cystectomy (RARC) in a single-center series and to evaluate the impact of the experience on perioperative outcomes. METHODS: Between March 2012 and January 2016, 41 patients underwent RARC associated with extended pelvic lymphadenectomy for muscle-invasive bladder cancer. All RARC included were performed by a single-surgeon in one center. Perioperative and oncological datas were collected prospectively...
September 2016: Progrès en Urologie
Fabrizio Dal Moro, Georges P Haber, Peter Wiklund, Abdullah E Canda, Mevlana D Balbay, Arnulf Stenzl, Filiberto Zattoni, Joan Palou, Inderbir Gill, James W Catto
In this practical review, we discuss current surgical techniques reported in the literature to perform Intracorporeal Urinary Diversion (ICUD) after Robotic Radical Cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with Extracorporeal Urinary Diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analysing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes...
August 31, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Ricardo Palmerola, Mary E Westerman, Mathew Fakhoury, Stephen A Boorjian, Lee Richstone
Ureteroarterial fistulas (UAFs) are defined as an abnormal communication between one of the major arteries and the ureter. Urologists most frequently encounter iatrogenic fistulas occurring in patients with a history of pelvic extirpative surgery, chronic ureteral catheterization, and history of pelvic radiation. We present two cases of UAFs in patients with no history of prior radiation, who underwent open radical cystectomy and robot-assisted radical cystectomy with intracorporeal ileal conduit. Both patients developed postoperative ureteroileal anastomotic leaks that were managed with indwelling ureteral catheters...
2016: J Endourol Case Rep
Mikkel Fode, Gyrithe L Pedersen, Nessn Azawi
OBJECTIVE: Between 2012 and 2014, nine consecutive patients with symptomatic urachal remnants were treated at Roskilde Hospital, Denmark, with a robot-assisted laparoscopic en bloc resection of their urachal remnants with partial cystectomy and umbilectomy with primary umbilicoplasty. The objective of this study is to report surgical results and give recommendations for the management of urachal remnants. MATERIALS AND METHODS: The patient group consisted of four women and five men with a median age of 59 years...
August 30, 2016: Scandinavian Journal of Urology
Antonio Cusano, Peter Haddock, Max Jackson, Ilene Staff, Joseph Wagner, Anoop Meraney
PURPOSE: To compare complications and outcomes in patients undergoing either open radical cystectomy (ORC) or robotic-assisted radical cystectomy (RRC). MATERIALS AND METHODS: We retrospectively identified patients that underwent ORC or RRC between 2003- 2013. We statistically compared preliminary oncologic outcomes of patients for each surgical modality. RESULTS: 92 (43.2%) and 121 (56.8%) patients underwent ORC and RRC, respectively. While operative time was shorter for ORC patients (403 vs...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Erdal Alkan, Abdullah Erdem Canda, Mirac Turan, Merve Yilmaz, Ahmet Oguz Ozkanli, Mevlana Derya Balbay
No abstract text is available yet for this article.
2016: Central European Journal of Urology
Erdal Alkan, Abdullah Erdem Canda, Altug Semiz, Ahmet Oguz Ozkanli, Merve Yilmaz, Mevlana Derya Balbay
No abstract text is available yet for this article.
2016: Central European Journal of Urology
Raj Satkunasivam, Christopher J D Wallis, Robert K Nam, Mihir Desai, Inderbir S Gill
Robot-assisted radical cystectomy (RARC) is an evolving technique for the treatment of muscle-invasive bladder cancer (MIBC); however, its effectiveness compared with open radical cystectomy (ORC) - the established modality - is debated. Six specific areas of evidence are critically important for supporting the continuing use of RARC for MIBC, including technical aspects of surgery, perioperative outcomes, complications, oncological outcomes, functional outcomes, and financial costs. Considerable progress has been made regarding these aspects and data show that RARC replicates the technical benchmarks of ORC in terms of success of cystectomy, lymph node dissection, and urinary diversion, and could offer advantages over the more-established technique...
September 2016: Nature Reviews. Urology
Pranav Sharma, Kamran Zargar-Shoshtari, Michael A Poch, Julio M Pow-Sang, Wade J Sexton, Philippe E Spiess, Scott M Gilbert
PURPOSE: The benefits of robotic-assisted radical cystectomy (RARC) are unclear, especially in patients with high-risk disease (pT3/T4). We evaluated pathological and postoperative outcomes of RARC versus open radical cystectomy (ORC) in these patients. METHODS: We identified bladder cancer patients treated with RARC or ORC from January 2010-August 2014. Clinicodemographic factors were examined for potential confounding. Our primary outcome of interest was positive soft-tissue surgical margins (STSMs)...
August 5, 2016: World Journal of Urology
Ahmed A Hussein, Shiva Dibaj, Nobuyuki Hinata, Erinn Field, Kathleen O'leary, Boris Kuvshinoff, James L Mohler, Gregory Wilding, Khurshid A Guru
OBJECTIVE: To develop quality assessment tool to evaluate surgical performance for robot-assisted radical cystectomy (RARC) program. METHODS: A prospectively maintained quality assurance database of 425 consecutive RARCs performed by a single surgeon between 2005 and 2015 was retrospectively reviewed. Potentially modifiable factors, related to the management and perioperative care of patients were used to evaluate patient care. Criteria included: Preoperative (administration of neoadjuvant chemotherapy); Operative (operative time <6...
August 1, 2016: Urology
R Ginot, B Rouget, H Bensadoun, G Pasticier, J-C Bernhard, G Capon, J-M Ferrière, G Robert
INTRODUCTION: Radical cystectomy remains the referent treatment of non-metastatic muscle-invasive bladder cancer (MIBC). The fast development of robotic surgery has led some teams to use it for the surgical treatment of the MIBC, in the hope of reducing postoperative morbidity. Urinary diversion by bladder substitution is a bypass option. The aim of our study was to compare the robot-assisted cystectomy with open cystectomy, with urinary diversion by bladder substitution. PATIENTS AND METHODS: Over a two-year period, all the patients who underwent a robot-assisted laparoscopic or open cystectomy with urinary diversion by bladder substitution have been included...
June 2016: Progrès en Urologie
D Nikoleishvili, Z Tchanturaia, G Managadze, G Koberidze, A Pertia
Bladder cancer is the ninth most commonly diagnosed malignant tumor worldwide. Radical cystectomy is the standard surgical treatment for non-metastatic, muscle-invasive bladder cancer and a recommended treatment of choice in a subset of highest-risk patients with non-muscle invasive disease. Recently, laparoscopic radical cystectomy has become an attractive alternative to an open counterpart and many centers worldwide have reported their early experiences with the technique. Laparoscopic radical cystectomy is a technically challenging procedure and current recommendations still consider it, with or without robotic assistance, to be experimental due to absence of long-term data on oncological and functional outcomes and possible selection bias in the reported series...
June 2016: Georgian Medical News
Dong Jae Bak, You Jin Lee, Myeong Jin Woo, Jae-Wook Chung, Yun-Sok Ha, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Bup Wan Kim, Tae Gyun Kwon
PURPOSE: The aim of this study was to assess the advantages of robotic surgery, comparing perioperative and oncological outcomes between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). MATERIALS AND METHODS: Between August 2008 and May 2014, 112 radical cystectomies (42 RARCs and 70 ORCs) were performed at a single academic institution following Institutional Review Board approval. Patient demographics, perioperative variables (e.g., complications), and oncologic outcomes including metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) were reported using the Kaplan-Meier analyses...
July 2016: Investigative and Clinical Urology
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