Advertisement

Robotic Intracorporeal Urinary Diversion for Bladder Cancer

  • Abdullah Erdem Canda
Chapter

Abstract

Robotic radical cystectomy, extended pelvic lymph node dissection with intracorporeal urinary diversion , is increasingly being applied in the surgical management of bladder cancer. Published literature suggests that this approach has similar short- and midterm oncological outcomes compared to open surgery. Robotic approach seems to have an advantage in terms of estimated blood loss, transfusion rate, length of hospital stay, and complications. Operative time, lymph node yield, and surgical margins seem to be similar. In the most experienced robotic centers, promising functional outcomes including urinary continence and erectile function have been reported. However, the numbers of patients included in the robotic series are limited in the published literature, and long-term data is not available yet. Therefore, presently it is not easy to make strict conclusions about this approach. In this chapter, an overview of the literature on this subject is summarized, and the surgical technique applied is presented including preoperative planning, setup, and postoperative care.

Keywords

Intracorporeal urinary diversion Robotic cystectomy Studer pouch Bladder cancer 

References

  1. 1.
    Huang GJ, Stein JP. Open radical cystectomy with lymphadenectomy remains the treatment of choice for invasive bladder cancer. Curr Opin Urol. 2007;17(5):369–75.CrossRefGoogle Scholar
  2. 2.
    Liss MA, Kader AK. Robotic-assisted laparoscopic radical cystectomy: history, techniques and outcomes. World J Urol. 2013;31(3):489–97.3.CrossRefGoogle Scholar
  3. 3.
    Hayn MH, Hussain A, Mansour AM, et al. The learning curve of robot-assisted radical cystectomy: results from the international robotic cystectomy consortium. Eur Urol. 2010 Aug;58(2):197–202.CrossRefGoogle Scholar
  4. 4.
    Collins JW, Tyritzis S, Nyberg T, Schumacher MC, Laurin O, Adding C, Jonsson M, Khazaeli D, Steineck G, Wiklund P, Hosseini A. Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder - what is the effect of the learning curve on outcomes? BJU Int. 2014;113(1):100–7.CrossRefGoogle Scholar
  5. 5.
    Herr H, Lee C, Chang S, Lerner S. Bladder Cancer Collaborative Group. Standardization of radical cystectomy and pelvic lymph node dissection for bladder cancer: a collaborative group report. J Urol. 2004;171(5):1823–8.CrossRefGoogle Scholar
  6. 6.
    Skinner EC, Stein JP, Skinner DG. Surgical benchmarks for the treatment of invasive bladder cancer. Urol Oncol. 2007;25(1):66–71.CrossRefGoogle Scholar
  7. 7.
    Stein JP, Cai J, Groshen S, Skinner DG. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: concept of lymph node density. J Urol. 2003;170(1):35–41.CrossRefGoogle Scholar
  8. 8.
    Leissner J, Hohenfellner R, Thüroff JW, Wolf HK. Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis. BJU Int. 2000;85(7):817–23.CrossRefGoogle Scholar
  9. 9.
    Herr HW, Faulkner JR, Grossman HB, et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol. 2004;22(14):2781–9.CrossRefGoogle Scholar
  10. 10.
    Canda AE, Atmaca AF, Arslan ME, Keske M, Cakici OU, Cakmak S, Kamaci D, Urer E. Robotic radical cystectomy in bladder cancer: is it the future? Open Access Surgery. 2014;7:47–57.CrossRefGoogle Scholar
  11. 11.
    Collins JW, Hosseini A, Adding C, Nyberg T, Koupparis A, Rowe E, Perry M, Issa R, Schumacher MC, Wijburg C, Canda AE, Balbay MD, Decaestecker K, Schwentner C, Stenzl A, Edeling S, Pokupić S, D'Hondt F, Mottrie A, Wiklund PN. Early recurrence patterns following totally Intracorporeal robot-assisted radical cystectomy: results from the EAU robotic urology section (ERUS) scientific working group. Eur Urol. 2017;71(5):723–6.CrossRefGoogle Scholar
  12. 12.
    Hussein AA, Saar M, May PR, Wijburg CJ, Richstone L, Wagner A, Wilson T, Yuh B, Redorta JP, Dasgupta P, Khan MS, Menon M, Peabody JO, Hosseini A, Gaboardi F, Mottrie A, Rha KH, Hemal A, Stockle M, Kelly J, Maatman TJ, Canda AE, Wiklund P, Guru KA. Collaborators. Early oncologic failure after robot-assisted radical cystectomy: results from the international robotic cystectomy consortium. J Urol. 2017 Jun;197(6):1427–36.CrossRefGoogle Scholar
  13. 13.
    Nguyen DP, Al Hussein A Awamlh B, O'Malley P, Khan F, Lewicki PJ, Golombos DM, Scherr DS. Factors impacting the occurrence of local, distant and atypical recurrences after robot-assisted radical cystectomy: a detailed analysis of 310 patients. J Urol. 2016;196(5):1390–6.CrossRefGoogle Scholar
  14. 14.
    Canda AE, Atmaca AF, Altinova S, Akbulut Z, Balbay MD. Robot-assisted nerve-sparing radical cystectomy with bilateral extended pelvic lymph node dissection (PLND) and intracorporeal urinary diversion for bladder cancer: initial experience in 27 cases. BJU Int. 2012 Aug;110(3):434–44.CrossRefGoogle Scholar
  15. 15.
    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.CrossRefGoogle Scholar
  16. 16.
    Johar RS, Hayn MH, Stegemann AP, et al. Complications after robot- assisted radical cystectomy: results from the international robotic cystectomy consortium. Eur Urol. 2013;64(1):52–7.CrossRefGoogle Scholar
  17. 17.
    Simone G, Papalia R, Misuraca L, Tuderti G, Minisola F, Ferriero M, Vallati G, Guaglianone S, Gallucci M. Robotic Intracorporeal Padua Ileal Bladder: Surgical Technique, Perioperative, Oncologic and Functional Outcomes. Eur Urol. 2016;pii: S0302–2838(16):30721–7.  https://doi.org/10.1016/j.eururo.2016.10.018. [Epub ahead of print]CrossRefGoogle Scholar
  18. 18.
    Al-Daghmin A, Kauffman EC, Shi Y, Badani K, Balbay MD, Canda E, Dasgupta P, Ghavamian R, Grubb R 3rd, Hemal A, Kaouk J, Kibel AS, Maatman T, Menon M, Mottrie A, Nepple K, Pattaras JG, Peabody JO, Poulakis V, Pruthi R, Palou Redorta J, Rha KH, Richstone L, Schanne F, Scherr DS, Siemer S, Stöckle M, Wallen EM, Weizer A, Wiklund P, Wilson T, Wilding G, Woods M, Guru KA. Efficacy of robot-assisted radical cystectomy (RARC) in advanced bladder cancer: results from the International Radical Cystectomy Consortium (IRCC). BJU Int. 2014;114(1):98–103.  https://doi.org/10.1111/bju.12569. Epub 2014 May 22CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Tyritzis SI, Hosseini A, Collins J, et al. Oncologic, functional, and com- plications outcomes of robot-assisted radical cystectomy with totally intracorporeal neobladder diversion. Eur Urol. 2013;64(5):734–41.CrossRefGoogle Scholar
  20. 20.
    Torrey RR, Chan KG, Yip W, et al. Functional outcomes and complications in patients with bladder cancer undergoing robotic- assisted radical cystectomy with extracorporeal Indiana pouch continent cutaneous urinary diversion. Urology. 2012;79(5):1073–8.CrossRefGoogle Scholar
  21. 21.
    Asimakopoulos AD, Campagna A, Gakis G, Corona Montes VE, Piechaud T, Hoepffner JL, Mugnier C, Gaston R. Nerve sparing, robot-assisted radical cystectomy with Intracorporeal bladder substitution in the male. J Urol. 2016 Nov;196(5):1549–57.CrossRefGoogle Scholar
  22. 22.
    Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol. 2010;57(2):196–201.CrossRefGoogle Scholar
  23. 23.
    Knox ML, El-Galley R, Busby JE. Robotic versus open radical cystectomy: identi cation of patients who bene t from the robotic approach. J Endourol. 2013;27(1):40–4.CrossRefGoogle Scholar
  24. 24.
    Styn NR, Montgomery JS, Wood DP, et al. Matched comparison of robotic-assisted and open radical cystectomy. Urology. 2012;79(6):1303–8.CrossRefGoogle Scholar
  25. 25.
    Sung HH, Ahn JS, Seo SI, et al. A comparison of early complications between open and robot-assisted radical cystectomy. J Endourol. 2012;26(6):670–5.CrossRefGoogle Scholar
  26. 26.
    Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R. Perioperative outcomes and oncologic ef cacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol. 2013;189(2):474–9.CrossRefGoogle Scholar
  27. 27.
    Gondo T, Yoshioka K, Nakagami Y, et al. Robotic versus open radical cystectomy: prospective comparison of perioperative and pathologic outcomes in Japan. Jpn J Clin Oncol. 2012;42(7):625–31.CrossRefGoogle Scholar
  28. 28.
    Ng CK, Kauffman EC, Lee MM, et al. A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol. 2010;57(2):274–81.CrossRefGoogle Scholar
  29. 29.
    Nepple KG, Strope SA, Grubb RL 3rd, Kibel AS. Early oncologic outcomes of robotic vs open radical cystectomy for urothelial cancer. Urol Oncol. 2013;31(6):894–8.CrossRefGoogle Scholar
  30. 30.
    Wang GJ, Barocas DA, Raman JD, Scherr DS. Robotic vs open radical cystectomy: prospective comparison of perioperative outcomes and pathological measures of early oncological ef cacy. BJU Int. 2008;101(1):89–93.PubMedGoogle Scholar
  31. 31.
    Kader AK, Richards KA, Krane LS, Pettus JA, Smith JJ, Hemal AK. Robot-assisted laparoscopic vs open radical cystectomy: comparison of complications and perioperative oncological outcomes in 200 patients. BJU Int. 2013;112(4):E290–4.CrossRefGoogle Scholar
  32. 32.
    Sterrett S, Mammen T, Nazemi T, et al. Major urological oncological surgeries can be performed using minimally invasive robotic or laparoscopic methods with similar early perioperative outcomes compared to conventional open methods. World J Urol. 2007;25(2):193–8.CrossRefGoogle Scholar
  33. 33.
    Bochner BH, Dalbagni G, Sjoberg DD, Silberstein J, Keren Paz GE, Donat SM, Coleman JA, Mathew S, Vickers A, Schnorr GC, Feuerstein MA, Rapkin B, Parra RO, Herr HW, Laudone VP. Comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: a randomized clinical trial. Eur Urol. 2015 Jun;67(6):1042–50.CrossRefGoogle Scholar
  34. 34.
    Shen Z, Sun Z. Systematic review and meta-analysis of randomised trials of perioperative outcomes comparing robot-assisted versus open radical cystectomy. BMC Urol. 2016 Sep 23;16(1):59.CrossRefGoogle Scholar
  35. 35.
    Hu JC, Chughtai B, O'Malley P, Halpern JA, Mao J, Scherr DS, Hershman DL, Wright JD, Sedrakyan A. Perioperative outcomes, health care costs, and survival after robotic-assisted versus open radical cystectomy: a National Comparative Effectiveness Study. Eur Urol. 2016 Jul;70(1):195–202.CrossRefGoogle Scholar
  36. 36.
    Atmaca AF, Canda AE, Gok B, Akbulut Z, Altinova S, Balbay MD. Open versus robotic radical cystectomy with intracorporeal Studer diversion. JSLS. 2015 Jan-Mar;19(1):e2014.00193.CrossRefGoogle Scholar
  37. 37.
    Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, Kassouf W, Muller S, Baldini G, Carli F, Naesheimh T, Ytrebo L, Revhaug A, Lassen K, Knutsen T, Aarsether E, Wiklund P, Patel HR. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS(®)) society recommendations. Clin Nutr. 2013;32(6):879–87.CrossRefGoogle Scholar
  38. 38.
    Baack Kukreja JE, Kiernan M, Schempp B, Siebert A, Hontar A, Nelson B, Dolan J, Noyes K, Dozier A, Ghazi A, Rashid HH, Wu G, Messing EM. Quality Improvement in Cystectomy Care with Enhanced Recovery (QUICCER) study. BJU Int. 2017 Jan;119(1):38–49.CrossRefGoogle Scholar
  39. 39.
    Collins JW, Patel H, Adding C, Annerstedt M, Dasgupta P, Khan SM, Artibani W, Gaston R, Piechaud T, Catto JW, Koupparis A, Rowe E, Perry M, Issa R, McGrath J, Kelly J, Schumacher M, Wijburg C, Canda AE, Balbay MD, Decaestecker K, Schwentner C, Stenzl A, Edeling S, Pokupić S, Stockle M, Siemer S, Sanchez-Salas R, Cathelineau X, Weston R, Johnson M, D’Hondt F, Mottrie A, Hosseini A, Wiklund PN. Enhanced Recovery After Robot-assisted Radical Cystectomy: EAU Robotic Urology Section Scientific Working Group Consensus View. Eur Urol. 2016;70(4):649–60.CrossRefGoogle Scholar
  40. 40.
    Akbulut Z, Canda AE, Ozcan MF, Atmaca AF, Ozdemir AT, Balbay MD. Robot-assisted laparoscopic nerve-sparing radical cystoprostatectomy with bilateral extended lymph node dissection and intracorporeal Studer pouch construction: outcomes of first 12 cases. J Endourol. 2011;25(9):1469–79.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Abdullah Erdem Canda
    • 1
  1. 1.Koc University, School of Medicine, Department of UrologyIstanbulTurkey

Personalised recommendations