The Hood Technique for Robot-Assisted Radical Cystoprostatectomy with Intracorporeal Neobladder

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• The Hood technique, initially for prostatectomy, preserves continence-related structures.
• Radical cystoprostatectomy (RARC) involves extensive dissection, requiring adaptation of the Hood technique.
• Intracorporeal neobladder reconstruction is a complex procedure following RARC.

Purpose of the Study:

• To adapt and describe the Hood technique for RARC with intracorporeal neobladder reconstruction.
• To report early feasibility, functional outcomes (continence), and oncologic outcomes.
• To evaluate the potential of this modified approach for preserving urinary continence.

Main Methods:

• Retrospective review of 40 male patients undergoing RARC with intracorporeal neobladder using the Hood technique (2019-2023).
• Continence defined as 0-1 pad/day; assessed via pad count at standardized intervals.
• Kaplan-Meier analysis for time to continence; perioperative and oncologic outcomes analyzed descriptively.

Main Results:

• Median operative time: 335 minutes; estimated blood loss: 400 mL; hospital stay: 4 days.
• Daytime continence reached 92% by 6 months; nighttime continence reached 62% by ≥12 months.
• Negative surgical margins for urothelial carcinoma; major complications occurred in 7.5-10% of patients.

Conclusions:

• The adapted Hood technique is feasible for RARC with intracorporeal neobladder.
• Encouraging early continence recovery was observed without short-term adverse oncologic outcomes.
• Further comparative studies are warranted to validate these findings.