[Urachal adenocarcinoma treated with robotic assisted laparoscopy partial cystectomy]
J I Monzó Gardiner1, M F García, J M Albornoz
1Sección Cirugía Robótica. Hospital Dr. Federico Abete. Malvinas Argentinas. Provincia de Buenos Aires. Argentina.
Objective:
To describe a case of urachal adenocarcinoma treated with robotic assisted laparoscopic partial cystectomy and en-bloc exeresis of urachus and umbilicus and bibliographic review.
Methods:
A 63 year-old man with hematuria and hypogastric pain. He was diagnosed of urachal adenocarcinoma by transurethral resection and axial tomography. We performed a robotic assisted laparoscopic partial cystectomy using a da Vinci® S HD (Intuitive Surgical System) device. We describe the surgical technique and examine total length of time for surgery and for console, pathology report, margin status, postoperative outcome and oncological status 7 months after surgery.
Results:
4 ports were used for robotic arms and one additional for the assistant. Cystoscopy was performed during surgery to mark tumor margins. Bladder was closed using a running suture with Poliglactin 0. Total length time for surgery was 2hs 28 minutes, console time was 1h54'. Two days later patient was discharged and no complication was reported. After two weeks Foley cathether was removed and bladder volume was 300ml. Pathology report informed undifferentiated urachal adenocarcinoma with perivesical tissue infiltration with margins free from tumor, corresponding to Sheldon IIIB and Ontario III classification. Seven months later patient was fee from recurrence.
Conclusion:
Robotic assisted laparoscopy partial cystectomy with en-bloc exeresis of urachal and umbilicus is feasible.