Robotic and laparoscopic radical cystectomy in the management of bladder cancer

To review the current status of robot-assisted and laparoscopic radical cystectomy (RARC and LRC) in the management of bladder cancer, published English literature was searched using the National Library of Medicine database. The experience with RARC is rapidly growing, and this minimally invasive option and has relatively better results than LRC. Both techniques allow an appropriate lymph node dissection in the hands of experienced and skilled surgeons at high-volume centers. The early and intermediate oncological outcomes of RARC and LRC compare favorably with open radical cystectomy (ORC). Extracorporeal urinary diversions are performed via a mini-incision in most cases and have better outcome than pure intracorporeal urinary diversions. RARC has taken over LRC at most of the centers where robot is available. The future of RARC with extracorporeal urinary diversion looks optimistic and has potential to supplant ORC, but with greater cost.