Robot-Assisted Anterior Pelvic Exenteration for Bladder Cancer in the Female

  • Jeffrey W. NixEmail author
  • Raj S. PruthiEmail author


Radical cystectomy remains a gold standard oncologic treatment for patients with muscle-invasive bladder cancer and for those with high-grade, recurrent, noninvasive tumors. The applications of robotics to female cystectomy have not been well described. However, given the successful application of robotics in male patients, and growing experience with robotics in female pelvic procedures in the gynecologic literature, the stage has been set for its application to anterior pelvic exenteration for female patients with bladder cancer.


Bladder Neck Radical Cystectomy Anterior Vaginal Wall Robotic Approach Endopelvic Fascia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 7.1

RARC in the female is demonstrated (MP4 76277 kb)


  1. 1.
    Cathelineau X, Arroyo C, Rozet F, Barret E, Vallancien G. Laparoscopic assisted radical cystectomy: the montsouris experience after 84 cases. Eur Urol. 2005;47:780.PubMedCrossRefGoogle Scholar
  2. 2.
    Simonato A, Gregori A, Lissiani A, Bozzola A, Galli S, Gaboardi F. Laparoscopic radical cystoprostatectomy: our experience in a consecutive series of 10 patients with a 3 years follow-Up. Eur Urol. 2005;47:785.PubMedCrossRefGoogle Scholar
  3. 3.
    Rhee JJ, Lebeau S, Smolkin M, Theodorescu D. Radical cystectomy with ileal conduit diversion: early prospective evaluation of the impact of robotic assistance. BJU Int. 2006;98:1059.PubMedCrossRefGoogle Scholar
  4. 4.
    Guru KA, Kim HL, Piacente PM, Mohler JL. Robot-assisted radical cystectomy and pelvic lymph node dissection: initial experience at Roswell Park Cancer Institute. Urology. 2007;69:469.PubMedCrossRefGoogle Scholar
  5. 5.
    Pruthi RS, Wallen EM. Robotic assisted laparoscopic radical cystoprostatectomy: operative and pathological outcomes. J Urol. 2007;178:814.PubMedCrossRefGoogle Scholar
  6. 6.
    Smith AB, Raynor M, Amling CL, et al. Multi-institutional analysis of robotic radical cystectomy for bladder cancer: perioperative outcomes and complications in 227 patients. J Laparoendosc Adv Surg Tech A. 2012;22(1):17–21.PubMedCrossRefGoogle Scholar
  7. 7.
    Swan K, Advincula AP. Role of robotic surgery in urogynecologic surgery and radical hysterectomy: how far can we go? Curr Opin Urol. 2011;21(1):78–83.PubMedCrossRefGoogle Scholar
  8. 8.
    Nezhat C, Saberi NS, Shahmohamady B, Nezhat F. Robotic-assisted laparoscopy in gynecological surgery. JSLS. 2006;10(3):317–20.PubMedGoogle Scholar
  9. 9.
    Stein JP, Skinner DG. Radical cystectomy – technique and outcomes. In: Lerner SP, Schoenberg MP, Sternberg CN, editors. Textbook of bladder cancer. Boca Raton, FL: Taylor and Francis; 2006. p. 445–69. Ref Type: Edited Book.Google Scholar
  10. 10.
    Hall MC, Chang SS, Dalbagni G, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178:2314.PubMedCrossRefGoogle Scholar
  11. 11.
    Lee KL, Freiha F, Presti Jr JC, Gill HS. Gender differences in radical cystectomy: complications and blood loss. Urology. 2004;63:1095.PubMedCrossRefGoogle Scholar
  12. 12.
    Hollenbeck BK, Miller DC, Taub D, et al. Identifying risk factors for potentially avoidable complications following radical cystectomy. J Urol. 2005;174:1231.PubMedCrossRefGoogle Scholar
  13. 13.
    Orvieto MA, DeCastro GJ, Trinh QD, et al. Oncological and functional outcomes after robot-assisted radical cystectomy: critical review of current status. Urology. 2011;78:977.PubMedCrossRefGoogle Scholar
  14. 14.
    Matsou A, Vrakas G, Doulgerakis M, Hatzimisios K, Zandes N, Saliangas K. Mechanical bowel preparation before elective colorectal surgery: is it necessary? Tech Coloproctol. 2011;15 Suppl 1:S59.PubMedCrossRefGoogle Scholar
  15. 15.
    Cao F, Li J, Li F. Mechanical bowel preparation for elective colorectal surgery: updated systematic review and meta-analysis. Int J Colorectal Dis. 2012;27(6):803–10.PubMedCrossRefGoogle Scholar
  16. 16.
    de Aguilar-Nascimento JE, Diniz BN, Do Carmo AV, Silveira EA, Silva RM. Clinical benefits after the implementation of a protocol of restricted perioperative intravenous crystalloid fluids in major abdominal operations. World J Surg. 2009;33:925.PubMedCrossRefGoogle Scholar
  17. 17.
    Lobo DN, Bostock KA, Neal KR, Perkins AC, Rowlands BJ, Allison SP. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet. 2002;359:1812.PubMedCrossRefGoogle Scholar
  18. 18.
    Magrina JF, Pawlina W, Kho RM, Magtibay PM. Robotic nerve-sparing radical hysterectomy: feasibility and technique. Gynecol Oncol. 2011;121:605.PubMedCrossRefGoogle Scholar
  19. 19.
    Hinata N, Murakami G, Abe S, et al. Detailed histological investigation of the female urethra: application to radical cystectomy. J Urol. 2012;187:451.PubMedCrossRefGoogle Scholar
  20. 20.
    Bhatta DN, Kessler TM, Mills RD, Burkhard F, Studer UE. Nerve-sparing radical cystectomy and orthotopic bladder replacement in female patients. Eur Urol. 2007;52:1006.CrossRefGoogle Scholar
  21. 21.
    Pruthi RS, Chun J, Richman M. Reducing time to oral diet and hospital discharge in patients undergoing radical cystectomy using a perioperative care plan. Urology. 2003;62:661.PubMedCrossRefGoogle Scholar
  22. 22.
    Herrell SD, Smith Jr JA. Robotic-assisted laparoscopic prostatectomy: what is the learning curve? Urology. 2005;66:105.PubMedCrossRefGoogle Scholar
  23. 23.
    Chang SS, Smith Jr JA, Wells N, Peterson M, Kovach B, Cookson MS. Estimated blood loss and transfusion requirements of radical cystectomy. J Urol. 2001;166:2151.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Urologic Oncology BranchNational Cancer Institute, National Institutes of HealthBethesdaUSA
  2. 2.Department of UrologyThe University of North Carolina at Chapel HillChapel HillUSA

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