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Updates on Robotic Intracorporeal Urinary Diversions.
1Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY, 10065, USA.
Current Urology Reports
|March 17, 2018
Summary
Robotic intracorporeal urinary diversion builds on open surgery principles. While promising for reducing complications, further trials are needed to confirm benefits after radical cystectomy.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Urinary diversion techniques have evolved over a century.
- Contemporary methods must adhere to established open surgical principles.
- Robotic intracorporeal urinary diversion represents a modern advancement.
Purpose of the Study:
- To review fundamental open surgical principles for urinary diversion.
- To outline robotic intracorporeal urinary diversion techniques.
- To evaluate the potential benefits and outcomes of robotic intracorporeal urinary diversion.
Main Methods:
- Review of open surgical principles for urinary diversion.
- Description of technical aspects of robotic intracorporeal urinary diversions.
- Analysis of perioperative outcomes from 100 consecutive intracorporeal urinary diversion cases integrated with Enhanced Recovery after Surgery (ERAS) protocols.
Main Results:
- Potential benefits include reduced gastrointestinal, ureteral stricture, and wound complications.
- In the ERAS cohort: 49% continent diversions, median length of stay 5 days (37% ≤4 days).
- High-grade complications and readmissions occurred in 22% and 20% of patients, respectively.
Conclusions:
- Robotic intracorporeal urinary diversion shows promising benefits.
- Integration with Enhanced Recovery after Surgery (ERAS) protocols is highlighted.
- High-quality randomized controlled trials are necessary to define its definitive role in radical cystectomy patients.
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