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Robotic cystectomy

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https://www.readbyqxmd.com/read/28431995/robot-assisted-laparoscopic-urachal-excision-in-children
#1
Haris Ahmed, Adam S Howe, Lori L Dyer, Ronnie G Fine, Jordan S Gitlin, Richard N Schlussel, Paul F Zelkovic, Lane S Palmer
OBJECTIVE: To report the first exclusively pediatric series of robot-assisted urachal remnant excisions in children. MATERIALS & METHODS: We reviewed the medical records of all children who underwent robot-assisted excision of urachal remnants from 2010 to 2016. For the procedure, a 3-port approach was performed in all cases. Excision of the urachus was performed, along with partial cystectomy if there was clear or suspected bladder involvement. Outcomes and complications were reviewed...
April 18, 2017: Urology
https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#2
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28405873/erratum-to-robotic-radical-cystectomy-technical-tips-and-tricks
#3
S S Goonewardene, D M Bolton, N Lawrentschuk
No abstract text is available yet for this article.
April 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28367408/robotic-assisted-laparoscopic-partial-cystectomy-as-treatment-for-pseudosarcomatous-fibromyxoid-tumor-of-the-bladder
#4
Ali Antar, Alexander Boyle, Jorge L Lockhart, Trushar Patel
This case is of a 26 year old female evaluated for gross hematuria and suprapubic pain found to have a large bladder tumor. She subsequently underwent successful robotic assisted laparoscopic partial cystectomy. Pathology revealed pseudosarcomatous fibromyxoid tumor, an uncommon lesion that occurs most frequently among young females and must be distinguished from other malignant lesions, as treatment may differ. Partial cystectomy via robotic approach has never been described in the literature as a treatment option for this type of bladder lesion...
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28350238/safety-and-effectiveness-of-robot-assisted-versus-open-radical-cystectomy-for-bladder-cancer-a-systematic-review-and-meta-analysis
#5
Soo Kyung Son, Na Rae Lee, Seok Ho Kang, Seon Heui Lee
OBJECTIVES: To evaluate the safety and effectiveness of robot-assisted radical cystectomy (RARC) compared with open radical cystectomy (ORC) in bladder cancer. METHODS: A literature search for the systematic review was conducted using international databases as well as domestic databases up to April 2015. Outcomes of interest included baseline characteristics, complication rates, perioperative, and oncologic outcomes. RESULTS: Twenty-four articles were finally selected for inclusion in the meta-analysis...
March 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28342641/procedure-specific-risks-of-thrombosis-and-bleeding-in-urological-cancer-surgery-systematic-review-and-meta-analysis
#6
REVIEW
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Philippe D Violette, Giacomo Novara, Rufus Cartwright, Richard Naspro, Reed A C Siemieniuk, Bassel Ali, Leyla Eryuzlu, Johanna Geraci, Judi Winkup, Daniel Yoo, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves balancing a lower risk of venous thromboembolism (VTE) against a higher risk of bleeding, a trade-off that critically depends on the risks of VTE and bleeding in the absence of prophylaxis (baseline risk). OBJECTIVE: To provide estimates of the baseline risk of symptomatic VTE and bleeding requiring reoperation in urological cancer surgery. EVIDENCE ACQUISITION: We identified contemporary observational studies reporting symptomatic VTE or bleeding after urological procedures...
March 22, 2017: European Urology
https://www.readbyqxmd.com/read/28336308/robotic-intracorporeal-continent-cutaneous-diversion
#7
Mihir M Desai, Giuseppe Simone, Andre Luis de Castro Abreu, Sameer Chopra, Mariaconsiglia Ferriero, Salvatore Guaglianone, Francesco Minisola, Daniel Park, Rene Sotelo, Michele Gallucci, Inderbir S Gill, Monish Aron
PURPOSE: Robotic intra-corporeal urinary diversion has mostly been utilized for ileal conduit or orthotopic neobladder diversion. Herein, we present the initial series, detailed technique and outcomes of robotic intra-corporeal Indiana pouch, with minimum 1-year follow-up. MATERIALS AND METHODS: Ten patients underwent robotic radical cystectomy, pelvic lymphadenectomy and intra-corporeal Indiana pouch urinary diversion for cancer (n=9) or benign disease (n=1). Data were collected prospectively...
March 21, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28336286/robotic-surgery-in-uro-oncology-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#8
REVIEW
Daniel Steffens, Ruban Thanigasalam, Scott Leslie, Bharvi Maneck, Jane M Young, Michael Solomon
Robotic surgery represents a new horizon in minimally-invasive urological surgery. This systematic review of the literature and meta-analysis examines the effectiveness of robotic surgery compared with laparoscopic or open surgery for major uro-oncological procedures. 25 articles reported findings from 8 trials of prostatectomy (4 trials) and cystectomy (4 trials) including 1033 participants. Robotic surgery is comparable to laparoscopic or open surgery for oncological outcomes, overall complications, and provides somewhat better functional outcome, when compared to laparoscopic and open surgery...
March 20, 2017: Urology
https://www.readbyqxmd.com/read/28267606/no-differences-in-population-based-readmissions-after-open-and-robotic-assisted-radical-cystectomy-implications-for-post-discharge-care
#9
Tudor Borza, Bruce L Jacobs, Jeffrey S Montgomery, Alon Z Weizer, Todd M Morgan, Khaled S Hafez, Cheryl T Lee, Benjamin Y Li, Hye Sung Min, Chang He, Scott M Gilbert, Jonathan E Helm, Mariel S Lavieri, Brent K Hollenbeck, Ted A Skolarus
OBJECTIVE: To inform whether readmission reduction strategies should consider surgical approach, we examined readmission differences between open and robotic-assisted radical cystectomy (RARC) using population-based data. METHODS: We identified patients who underwent cystectomy between January 2010 and September 2013 based on International Classification of Diseases-9th edition codes and administrative claims from a large, national US health insurer (Clinformatics Data Mart Database, OptumInsight, Eden Prairie, MN)...
March 4, 2017: Urology
https://www.readbyqxmd.com/read/28257782/natural-history-predictors-and-management-of-uretero-enteric-strictures-after-robot-assisted-radical-cystectomy
#10
Youssef E Ahmed, Ahmed A Hussein, Paul R May, Basim Ahmad, Taimoor Ali, Prasanna Kumar, Khurshid A Guru
PURPOSE: Uretero-enteric strictures (UES) represent the most common complication requiring reoperation after radical cystectomy. Our objective was to investigate the prevalence, outcomes, predictors and management of UES. METHODS: Retrospective review of our quality assurance RARC database and identified patients who developed UES. Data was reviewed for demographics, perioperative outcomes and UES characteristics. Kaplan Meier method was used to compute time to UES and multivariable stepwise regression to evaluate predictors of UES...
February 28, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28256704/a-comprehensive-guide-to-perioperative-management-and-operative-technique-for-robotic-cystectomy-with-intracorporeal-urinary-diversion
#11
Wei Shen Tan, Benjamin W Lamb, Ashwin Sridhar, Timothy P Briggs, John D Kelly
Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion...
February 27, 2017: Urologia
https://www.readbyqxmd.com/read/28220593/robot-assisted-approach-to-w-configuration-urinary-diversion-a-step-by-step-technique
#12
Ahmed A Hussein, Youssef E Ahmed, Justen D Kozlowski, Paul May, John Nyquist, Sandra Sexton, Leslie Curtin, James O Peabody, Hassan Abol-Enein, Khurshid A Guru
INTRODUCTION: To describe a detailed step-by-step approach of our technique to robot-assisted intracorporeal "W" orthotopic ileal neobladder (ICNB). METHODS: Five patients underwent robot-assisted radical cystectomy (RARC), extended pelvic lymph node dissection (ePLND) and ICNB. ICNB was divided into 6 key steps to facilitate and enable a detailed analysis and auditing of the technique. No conversion to open surgery was required. Timing for each step was noted. All patients had at least 3 months of follow up...
February 20, 2017: BJU International
https://www.readbyqxmd.com/read/28214574/minimally-invasive-versus-open-approach-for-cystectomy-trends-in-the-utilization-and-demographic-or-clinical-predictors-using-the-national-cancer-database
#13
Andrew G Bachman, Alexander A Parker, Marshall D Shaw, Brian W Cross, Kelly L Stratton, Michael S Cookson, Sanjay G Patel
OBJECTIVE: To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. METHODS: We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database. Approach was stratified by open vs minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis were used to assess the relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28209455/port-site-metastases-after-robotic-radical-cystectomy-a-systematic-review-and-management-options
#14
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Senthil Nathan, Tim Briggs, Arjun Shankar, Navin Ramachandran, Alex Freeman, Anita Mitra, John D Kelly
BACKGROUND: Port-site metastases (PSMs) are a rare occurrence after robotic surgery. For robot-assisted radical cystectomy (RARC), isolated cases have been reported but management has not been previously described. We present a case of PSM that occurred after RARC and report the results of our systematic review of previously reported PSMs and describe the treatment options. Search Criteria and Methods: We describe a case of a PSM in a 55-year-old man who had undergone intracorporeal RARC...
June 29, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28128912/robotic-assisted-radical-cystoprostatectomy-and-intracorporeal-ileal-conduit-urinary-diversion-for-a-kidney-transplant-recipient
#15
Peter A Caputo, Daniel Ramirez, Matthew Maurice, Ryan Nelson, Onder Kara, Ercan Malkoc, David Goldfarb, Jihad Kaouk
INTRODUCTION AND OBJECTIVES: Robotic assisted radical cystectomy (RARC) is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. MATERIALS AND METHODS: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28111222/intentional-omission-of-ureteral-stents-during-robotic-assisted-intracorporeal-ureteroenteric-anastomosis-is-it-safe-and-feasible
#16
Wei Phin Tan, Patrick Whelan, Leslie A Deane
OBJECTIVE: To describe the surgical technique we used to perform a stentless intracorporeal ureteroenteric anastomosis and to determine the outcomes in this initial series. METHODS: We performed a retrospective review of a prospective database of all patients undergoing robotic-assisted intracorporeal urinary diversion with stentless ureteroenteric anastomosis between March 2014 and July 2016. Diversions were performed at the time of either robotic-assisted laparoscopic cystectomy for bladder cancer or urinary diversion for other indications...
January 19, 2017: Urology
https://www.readbyqxmd.com/read/28106242/symplastic-glomus-tumor-of-the-urinary-bladder-treated-by-robot-assisted-partial-cystectomy-a-case-report-and-literature-review
#17
Franco Palmisano, Franco Gadda, Matteo G Spinelli, Marco Maggioni, Bernardo Rocco, Emanuele Montanari
Glomus tumors arising in the urinary bladder are extremely rare, and only two cases have been reported in the English Literature. We present a case of a 58-year-old man with an asymptomatic mass of the anterior wall of the bladder that measured 2.5 × 2.5 cm. Endoscopic excision was performed, and the tumor was diagnosed as symplastic glomus tumor. The patient finally underwent robotic-assisted partial cystectomy, and he remains healthy without any recurrence to date.After reviewing this case and previous reports, we analyzed the clinicopathologic features and treatment options for this rare neoplasm...
January 16, 2017: Urologia
https://www.readbyqxmd.com/read/28070738/robotic-assisted-laparoscopic-radical-cystectomy-with-stentless-intracorporeal-modified-ves-pa-neobladder-early-experience
#18
Patrick Whelan, Wei Phin Tan, Dimitri Papagiannopoulos, Philip Omotosho, Leslie Deane
This study aimed at demonstrating the feasibility of robotic assisted laparoscopic radical cystectomy with pure intracorporeal modified Ves.Pa neobladder with stentless ureteroileal anastomosis. Pure intracorporeal robotic assisted laparoscopic technique has been recently developed with a select number of high-volume centers utilizing various operative and neobladder techniques. We reviewed the patient characteristics, operative details and perioperative courses in the two patients who have undergone robotic assisted laparoscopic radical cystectomy with pure intracorporeal modified Ves...
January 9, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28013038/potential-implications-of-shortening-length-of-stay-following-radical-cystectomy-in-a-pre-eras-population
#19
Takahiro Osawa, Sapan N Ambani, Kola Olugbade, Ted A Skolarus, Alon Z Weizer, Jeffrey S Montgomery, Chang He, Khaled S Hafez, Brent K Hollenbeck, Cheryl T Lee, James E Montie, Ganesh S Palapattu, Todd M Morgan
OBJECTIVE: To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge. MATERIALS AND METHODS: The analytic cohort comprised 484 consecutive patients with 90-day follow-up who underwent RC at our institution from 2005 to 2012 and with LOS ≤9 days. Patients were categorized according to LOS as short (s-LOS; ≤5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grades 3-5) occurring within 90 days after discharge...
December 21, 2016: Urology
https://www.readbyqxmd.com/read/28009143/robotic-intracorporeal-urinary-diversion-practical-review-of-current-surgical-techniques
#20
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. Analyzing 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...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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