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Robotic cystectomy

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https://www.readbyqxmd.com/read/28267606/no-differences-in-population-based-readmissions-after-open-and-robotic-assisted-cystectomy-implications-for-post-discharge-care
#1
Tudor Borza, Bruce L Jacobs, Jeffrey S Montgomery, Alon Z Weizer, Todd M Morgan, Khaled S Hafez, Cheryl T Lee, Benjamin Y, 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 ICD-9 codes and administrative claims from a large, national US health insurer (Clinformatics(TM) Data Mart Database, OptumInsight, Eden Prairie, MN)...
March 3, 2017: Urology
https://www.readbyqxmd.com/read/28257782/natural-history-predictors-and-management-of-uretero-enteric-strictures-after-robot-assisted-radical-cystectomy
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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-uretero-enteric-anastomosis-is-it-safe-and-feasible
#8
Wei Phin Tan, Patrick Whelan, Leslie Deane
OBJECTIVE: To describe the surgical technique we use to perform a stentless intracorporeal uretero-enteric 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 uretero-enteric anastomosis between March 2014 and July 2016. Diversions were performed either at the time of 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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28008756/cost-effectiveness-and-robot-assisted-urologic-surgery-does-it-make-dollars-and-sense
#13
Ryan W Dobbs, Brenden P Magnan, Nikita Abhyankar, Ashok K Hemal, Ben Challacombe, Jim Hu, Prokar Dasgupta, Francesco Porpiglia, Simone Crivellaro
INTRODUCTION: The introduction of the robotic surgical platform has led to distinct changes in practice patterns and the utilization of minimally invasive surgery in urology. While use of the robotic system is associated with improvements in perioperative outcomes such as estimated blood loss and hospital stay, there are significant fixed and variable costs with the purchase, maintenance and use of the robotics system that has led many authors to investigate the cost effectiveness of robotic urologic surgery...
December 22, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27993668/early-oncologic-failure-after-robot-assisted-radical-cystectomy-results-from-the-international-robotic-cystectomy-consortium
#14
Ahmed A Hussein, Matthias Saar, Paul R May, Carl J Wijburg, Lee Richstone, Andrew Wagner, Timothy Wilson, Bertram Yuh, Joan Palou Redorta, Prokar Dasgupta, Mohammad Shamim Khan, Mani Menon, James O Peabody, Abolfazl Hosseini, Franco Gaboardi, Alexandre Mottrie, Koon-Ho Rha, Ashok Hemal, Michael Stockle, John Kelly, Thomas J Maatman, Abdullah Erdem Canda, Peter Wiklund, Khurshid A Guru
PURPOSE: We sought to investigate the prevalence and variables associated with early oncologic failure. MATERIALS AND METHODS: We retrospectively reviewed the IRCC (International Radical Cystectomy Consortium) database of patients who underwent robot-assisted radical cystectomy since 2003. The final cohort comprised a total of 1,894 patients from 23 institutions in 11 countries. Early oncologic failure was defined as any disease relapse within 3 months of robot-assisted radical cystectomy...
December 18, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27987527/development-validation-and-clinical-application-of-pelvic-lymphadenectomy-assessment-and-completion-evaluation-intraoperative-assessment-of-lymph-node-dissection-after-robot-assisted-radical-cystectomy-for-bladder-cancer
#15
Ahmed A Hussein, Nobuyuki Hinata, Shiva Dibaj, Paul R May, Justen D Kozlowski, Hassan Abol-Enein, Ronney Abaza, Daniel Eun, Mohamed S Khan, James L Mohler, Piyush Agarwal, Kamal Pohar, Richard Sarle, Ronald Boris, Sridhar S Mane, Alan Hutson, Khurshid A Guru
OBJECTIVES: To develop a scoring tool, Pelvic Lymphadenectomy Appropriateness and Completion Evaluation (PLACE), to assess the intraoperative completeness and appropriateness of pelvic lymph node dissection (PLND) following robot-assisted radical cystectomy (RARC). PATIENTS, SUBJECTS AND METHODS: A panel of 11 open and robotic surgeons developed the content and structure of PLACE. The PLND template was divided into three zones. In all, 21 de-identified videos of bilateral robot-assisted PLNDs were assessed by the 11 experts using PLACE to determine inter-rater reliability...
December 17, 2016: BJU International
https://www.readbyqxmd.com/read/27980085/the-feasibility-and-effectiveness-of-robot-assisted-radical-cystectomy-after-neoadjuvant-chemotherapy-in-patients-with-muscle-invasive-bladder-cancer
#16
Takuya Koie, Chikara Ohyama, Hayato Yamamoto, Atsushi Imai, Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Tohru Yoneyama, Yuki Tobisawa, Atsushi Yamauchi, Toru Shimazui, Mikinobu Ohtani
OBJECTIVES: The aim of this study was to compare 29 muscle-invasive bladder cancer patients who received neoadjuvant chemotherapy (NAC) followed by immediate robot-assisted radical cystectomy (RARC) with those who underwent minimum-incision endoscopic RC (MIE-RC). METHODS: We retrospectively reviewed the charts of 430 consecutive patients who underwent RC and bilateral pelvic node dissection (PLND) between May 1994 and July 2016. Our study focused on patients with MIBC who had histologically confirmed stage T2-T4aN0M0 urothelial carcinoma of the bladder and received NAC prior to surgery...
December 15, 2016: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27909547/gastrointestinal-tract-access-for-urological-natural-orifice-transluminal-endoscopic-surgery
#17
REVIEW
Olga Miakicheva, Zachary Hamilton, Alp T Beksac, Sean W Berquist, Abd-Elrahman Hassan, Marc Holden, Ithaar H Derweesh
We conducted a literature review of natural orifice transluminal endoscopic surgery (NOTES), focusing on urologic procedures with gastrointestinal tract access, to update on the development of this novel surgical approach. As part of the methods, a comprehensive electronic literature search for NOTES was conducted using PubMed and Cochrane Library from March 2002 to February 2016 for papers reporting urologic procedures performed utilizing gastrointestinal tract access. A total of 11 peer-reviewed studies examining utility of gastrointestinal access for NOTES urologic procedures were noted, with the first report in 2007...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27908636/impact-of-neoadjuvant-chemotherapy-on-complications-of-minimally-invasive-radical-cystectomy
#18
D Lizée, R S Salas, E Barret, M Galiano, E Di Trapani, F Montorsi, X Cathelineau
BACKGROUND: Neoadjuvant chemotherapy (NC) before minimally invasive radical cystectomy (MIRC) is considered a standard of care in muscle-invasive bladder cancer or recurrent high-risk non-muscle-invasive bladder cancer. OBJECTIVE: To evaluate the impact of NC on morbidity and mortality after MIRC. DESIGN, SETTING, AND PARTICIPANTS: We prospectively evaluated 135 patients who underwent MIRC (laparoscopic: n=100; robotic: n=35) between 2007 and 2013 with ≥90 days of follow-up (median age: 66 year)...
March 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27908634/systematic-review-of-perioperative-outcomes-and-complications-after-open-laparoscopic-and-robot-assisted-radical-cystectomy
#19
A Palazzetti, R Sanchez-Salas, P Capogrosso, E Barret, N Cathala, A Mombet, D Prapotnich, M Galiano, F Rozet, X Cathelineau
Radical cystectomy and regional lymph node dissection is the standard treatment for localized muscle-invasive and for high-risk non-muscle-invasive bladder cancer, and represents one of the main surgical urologic procedures. The open surgical approach is still widely adopted, even if in the last two decades efforts have been made in order to evaluate if minimally invasive procedures, either laparoscopic or robot-assisted, might show a benefit compared to the standard technique. Open radical cystectomy is associated with a high complication rate, but data from the laparoscopic and robotic surgical series failed to demonstrate a clear reduction in post-operative complication rates compared to the open surgical series...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27901350/blood-transfusion-requirement-and-not-preoperative-anemia-are-associated-with-perioperative-complications-following-intracorporeal-robot-assisted-radical-cystectomy
#20
Wei Shen Tan, Benjamin W Lamb, Pramit Khetrapal, Mae-Yen Tan, Melanie El Tan, Ashwin Sridhar, Elizabeth Cervi, Simon Rodney, Gerald Busuttil, Senthil Nathan, John Hines, Greg Shaw, Anna Mohammed, Hilary Baker, Timothy P Briggs, Andrew Klein, Toby Richards, John D Kelly
OBJECTIVES: To assess the prevalence of preoperative anemia and the impact of preoperative anemia and blood transfusion requirement on 30- and 90-day complications in a cohort of patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). PATIENTS AND METHODS: IRARC was performed on 166 patients between June 2011 and March 2016. Prospective data were collected for patient demographics, clinical and pathologic characteristics, perioperative variables, transfusion requirements, and hospital length of stay...
February 2017: Journal of Endourology
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