Abstract
Robot-assisted radical cystectomy (RARC) has gained popularity as a minimally invasive alternative to the standard open approach, bringing to potential advantages in terms of lower intraoperative blood loss, postoperative blood transfusions, and morbidity, leading to a shorter hospital stay. Moreover, due to the enhanced three-dimensional (3D) visualization and high precision movements, the robotic approach seems to give significant advantages when performing a nerve-sparing surgery in male patients. In fact, several steps of the surgical procedure are at risk of nerve damage and may be performed respecting the neural periprostatic network. In this chapter, we describe the step-by-step surgical technique of both non-nerve-sparing and nerve-sparing RARC. We described the patient positioning, considering the differences in the docking step between da Vinci® X, Si, and Xi systems. Later on, the dissection of the ureters, posterior dissection, lateral dissection, anterior dissection, and the dissection of the urethra are described in both approaches.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Professionals S-O. EAU Guidelines: muscle-invasive and metastatic bladder cancer. Uroweb. https://uroweb.org/guideline/bladder-cancer-muscle-invasive-and-metastatic/. Accessed 25 May 2021.
Novara G, Catto JWF, Wilson T, et al. Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy. Eur Urol. 2015;67(3):376–401. https://doi.org/10.1016/j.eururo.2014.12.007.
Musch M, Janowski M, Steves A, et al. Comparison of early postoperative morbidity after robot-assisted and open radical cystectomy: results of a prospective observational study. BJU Int. 2014;113(3):458–67. https://doi.org/10.1111/bju.12374.
Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results – ClinicalKey. https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0302283809010288?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0302283809010288%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F. Accessed 25 May 2021.
Desai MM, Gill IS. “The devil is in the details”: randomized trial of robotic versus open radical cystectomy. Eur Urol. 2015;67(6):1053–5. https://doi.org/10.1016/j.eururo.2015.01.017.
Parekh DJ, Reis IM, Castle EP, et al. Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial. Lancet. 2018;391(10139):2525–36. https://doi.org/10.1016/S0140-6736(18)30996-6.
Khan MS, Gan C, Ahmed K, et al. A single-centre early phase randomised controlled three-arm trial of open, robotic, and laparoscopic radical cystectomy (CORAL). Eur Urol. 2016;69(4):613–21. https://doi.org/10.1016/j.eururo.2015.07.038.
Collins JW, Tyritzis S, Nyberg T, et al. Robot-assisted radical cystectomy: description of an evolved approach to radical cystectomy. Eur Urol. 2013;64(4):654–63. https://doi.org/10.1016/j.eururo.2013.05.020.
Nyame YA, Zargar H, Ramirez D, et al. Robotic-assisted laparoscopic bilateral nerve sparing and apex preserving cystoprostatectomy in young men with bladder cancer. Urology. 2016;94:259–64. https://doi.org/10.1016/j.urology.2016.04.026.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
1 Electronic Supplementary Material
Freeing ureter male definitieve versie + tekst (MP4 309222 kb)
Posterior dissection male volledige versie + tekst (MP4 231256 kb)
Lateral dissection non nerve sparing male dia+ volledige film + tekst (MP4 244142 kb)
Apical dissection male dia + volledige film + tekst (MP4 277652 kb)
Nerve sparing RARC (MOV 218205 kb)
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Palou, J., D’Hont, F., Annerstedt, M., Piana, A. (2022). Step-by-Step Approach to Robot-Assisted Male Cystectomy. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_56
Download citation
DOI: https://doi.org/10.1007/978-3-031-00363-9_56
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-00362-2
Online ISBN: 978-3-031-00363-9
eBook Packages: MedicineMedicine (R0)