Current status of minimally invasive radical cystectomy: an outcome-based comparison

Minimally invasive approaches to radical cystectomy are 20 years old. Available data suggest that minimally invasive radical cystectomy can provide comparable outcomes to open radical cystectomy despite the scarcity of level 1-2 evidence. Perioperative, functional and early oncologic outcomes seem comparable between the two surgical approaches. Robotic technology has allowed more surgeons to perform minimally invasive radical cystectomy and has simplified technically demanding steps that posed problems in conventional laparoscopy. This is evident by the rapid dissemination of robotics in many bladder cancer centers worldwide and by the numerous emerging series of robot-assisted intracorporeal urinary diversion. Until more data are available regarding the oncologic performance of minimally invasive radical cystectomy, open radical cystectomy remains the gold standard procedure for now.