Robot-Assisted Radical Cystectomy: Recommendations from Latin American Experts Consensus on Surgical Strategy,...

Area of Science:

• Uro-oncology
• Robotic Surgery
• Evidence-Based Medicine

Background:

• Robot-assisted radical cystectomy (RARC) is a complex procedure requiring standardized best practices.
• Latin American uro-oncology and robotic surgery experts convened to address practice variations.

Purpose of the Study:

• To establish contemporary, evidence-informed recommendations for RARC and urinary reconstruction.
• To integrate current evidence with expert experience for Latin American centers.

Main Methods:

• Modified Delphi consensus process involving 42 experts.
• Comprehensive literature review (Medline, Scopus, Web of Science) up to November 2025.
• Incorporation of EAU, AUA/ASCO/SUO, and NCCN guidelines.

Main Results:

• Support for routine Enhanced Recovery After Surgery (ERAS) protocols, frailty assessment, extended lymph node dissection, and perioperative therapy.
• Intracorporeal urinary diversion linked to better recovery and fewer wound complications.
• Individualized approach recommended for orthotopic neobladder reconstruction; RARC feasible in complex cases at high-volume centers.

Conclusions:

• Expert consensus provides actionable recommendations for RARC and urinary reconstruction.
• Aims to standardize practice, enhance perioperative care, and improve oncological and functional outcomes.
• Highlights the need for future prospective studies to validate recommendations.