Robotic orthotopic neobladder formation is one of the most challenging procedures in urological surgery and to date performed only in a few specialized centres. In recent years, the principles of open bladder reconstruction have been successfully translated to robotic-assisted surgery. Several techniques of reservoir formation have been described, with most of them creating a low-pressure bladder using a cross folded segment of ileum.
With progress in surgical technique and experience, operating times are now routinely equivalent to open procedures in high-volume centres. Complication rates are comparable to open surgery and in carefully selected patients, robotic-assisted reconstruction has become extremely successful. The key aspects in preventing complications include patient selection, meticulous preparation of the procedure, careful positioning and adherence to sound surgical principles. Post-operative care following the guidelines of enhanced recovery and close follow-up are further pre-requisites of a successful programme.
This chapter will focus on patient selection and preparation, technical details of the procedure and post-operative care necessary to minimize complications after robotic orthotopic neobladder formation.
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