Early Experience With Robotic-Assisted Radical Cystectomy: A Six-Case Series From a UK Centre

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robotic-assisted radical cystectomy (RARC) offers a minimally invasive approach for bladder cancer.
• It is an alternative to open radical cystectomy for muscle-invasive and high-risk non-muscle-invasive bladder cancer.
• This study reports initial outcomes from the first six RARC procedures at a UK tertiary center.

Purpose of the Study:

• To evaluate the early perioperative and oncological outcomes of the first six robotic-assisted radical cystectomies performed at a UK tertiary center.
• To assess the safety and feasibility of introducing RARC in a new clinical setting.
• To establish a baseline for future comparative studies.

Main Methods:

• A retrospective review of the first six RARC cases performed between May and July 2025.
• Data collection included patient demographics, operative details, complications (Clavien-Dindo grading), pathology, and follow-up.
• Analysis focused on perioperative safety, early complications, and initial oncological status.

Main Results:

• Six patients (median age 65.5 years, 4 male) underwent RARC with no intraoperative transfusions or conversions to open surgery.
• Median operative time was 466.5 minutes; estimated blood loss ranged from 200-900 mL.
• Two postoperative ileus and one stoma retraction occurred, managed conservatively. No 30- or 90-day mortality was observed. Five of six cases had negative surgical margins.

Conclusions:

• Robotic-assisted radical cystectomy was safely introduced at the center, demonstrating perioperative outcomes consistent with international early series.
• The procedure appears feasible and safe for bladder cancer treatment in this initial cohort.
• Longer follow-up is necessary to confirm oncological control and functional results.