Robotic bladder diverticulectomy: step-by-step extravesical posterior approach - technique and outcomes

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Symptomatic bladder diverticula (BD) can cause significant lower urinary tract symptoms (LUTS).
• Traditional surgical approaches may be associated with considerable morbidity.
• Robotic extravesical posterior surgical bladder diverticulectomy (RBD) is an emerging technique for managing posterior BD.

Purpose of the Study:

• To evaluate the feasibility and outcomes of robotic extravesical posterior surgical bladder diverticulectomy (RBD).
• To assess the safety and efficacy of RBD in treating symptomatic posterior bladder diverticula (BD).

Main Methods:

• Retrospective review of patients who underwent robotic bladder diverticulectomy (RBD) for posterior BD.
• Data collected included baseline characteristics, operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), and postoperative complications.
• Functional outcomes and post-voiding residual (PVR) volumes were assessed at follow-up.

Main Results:

• Six patients underwent RBD with a median BD diameter of 7.1 cm and median preoperative PVR of 300 ml.
• Median operative time was 112.5 minutes, with a median estimated blood loss of 25.8 ml and median LOS of 7 days.
• One patient experienced a minor early complication; no major complications occurred. Postoperative PVR was minimal, and LUTS resolved by 6-month follow-up.

Conclusions:

• Robotic extravesical posterior surgical bladder diverticulectomy (RBD) is a safe and feasible treatment for posterior bladder diverticula (BD).
• The procedure demonstrates excellent perioperative and functional outcomes, including resolution of LUTS.
• Enhanced visualization and instrumentation of robotic surgery facilitate precise dissection and reconstruction.