[Robot-assisted radical cystectomy with neobladder formation]

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder formation is a complex procedure for treating muscle-invasive bladder cancer (BCa).
• Minimally invasive techniques aim to reduce morbidity associated with traditional open surgeries.

Purpose of the Study:

• To describe the main surgical stages of RARC with intracorporeal neobladder formation.
• To analyze the short-term oncological and functional outcomes of this procedure.

Main Methods:

• Sixteen patients underwent RARC with ileocystoplasty for bladder cancer or radiation-induced fistula.
• The procedure involved meticulous dissection, pelvic lymph node dissection, ileal resection, and intracorporeal neobladder construction using the Nesbit technique for ureteral reimplantation.

Main Results:

• The mean operative time was 380 minutes with minimal blood loss, avoiding transfusions in most cases.
• Short-term complications occurred in 43.7% of patients (Clavien-Dindo class I-IV), with most managed conservatively.
• Late complications included upper urinary tract infections, with one mortality due to unrelated causes.

Conclusions:

• RARC with intracorporeal neobladder is a viable minimally invasive option for muscle-invasive BCa.
• A standardized, stepwise surgical approach may optimize outcomes and potentially decrease complication rates.