The past decade has witnessed a dramatic increase in utilization of robot-assisted radical cystectomy (RARC). RARC has been shown to offer some perioperative benefits in terms of blood loss, transfusion rates, hospital stay, and recovery when compared with its open counterpart without jeopardizing oncologic outcomes. In this article, we review the indications, perioperative care, and describe the “Technique of Spaces” of RARC employed at our institution, and highlight the key steps for male RARC.
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References
1.
MatulewiczRS, DeLanceyJO, ManjunathA, TseJ, KunduSD, MeeksJJ. National comparison of oncologic quality indicators between open and robotic-assisted radical cystectomy. Urol Oncol, 2016; 34:431.e9–431.e15.
NixJ, SmithA, KurpadR, NielsenME, WallenEM, PruthiRS. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: Perioperative and pathologic results. Eur Urol, 2010; 57:196–201.
4.
WangGJ, BarocasDA, RamanJD, ScherrDS. Robotic vs open radical cystectomy: Prospective comparison of perioperative outcomes and pathological measures of early oncological efficacy. BJU Int, 2008; 101:89–93.
5.
KnoxML, El-GalleyR, BusbyJE. Robotic versus open radical cystectomy: Identification of patients who benefit from the robotic approach. J Endourol, 2013; 27:40–44.
6.
NeppleKG, StropeSA, GrubbRL, KibelAS. Early oncologic outcomes of robotic vs. open radical cystectomy for urothelial cancer. Urol Oncol, 2013; 31:894–898.
7.
PochMA, RazaJ, NyquistJ, GuruKA. Tips and tricks to robot-assisted radical cystectomy and intracorporeal diversion. Curr Opin Urol, 2013; 23:65–71.
8.
ClarkPE, SpiessPE, AgarwalN, et al.NCCN guidelines insights: Bladder cancer, version 2.2016. J Natl Compr Canc Netw, 2016; 14:1213–1224.
9.
ZigeunerR. Bladder cancer in 2016: News in diagnosis, treatment, and risk group assessment. Nat Rev Urol, 2017; 14:74–76.
10.
CollinsJW, PatelH, AddingC, et al.Enhanced recovery after robot-assisted radical cystectomy: EAU Robotic Urology Section Scientific Working Group Consensus View. Eur Urol, 2016; 70:649–660.
11.
GustafssonU, ScottMJ, SchwenkW, et al.Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J Surg, 2013; 37:259–284.
12.
BarrassBJR, ThurairajaR, CollinsJW, GillattD, PersadRA. Optimal nutrition should improve the outcome and costs of radical cystectomy. Urol Int, 2006; 77:139–142.
13.
DalyJM, LiebermanMD, GoldfineJ, ShouJ, WeintraubF, RosatoEF, LavinP. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: Immunologic, metabolic, and clinical outcome. Surgery, 1992; 112:56–67.
CerantolaY, ValerioM, PerssonB, et al.Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS®) society recommendations. Clin Nutr, 2013; 32:879–887.
19.
HaynMH, AgarwalPK, GuruKA. Robot-assisted radical cystectomy in male: Technique of spaces. In: HemalA, MenonM, eds. Robotics in Genitourinary Surgery. London: Springer, 2011, pp. 503–510.
20.
OverendTJ, AndersonCM, LucySD, BhatiaC, JonssonBI, Timmermans CThe effect of incentive spirometry on postoperative pulmonary complications: A systematic review. Chest, 2001; 120:971–978.
21.
ChoiH, KangSH, YoonDK, et al.Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: A prospective randomized comparative study. Urology, 2011; 77:884–890.
22.
TobisS, HeinlenJE, RuelN, LauC, KawachiM, WilsonT, ChanK. Effect of alvimopan on return of bowel function after robot-assisted radical cystectomy. J Laparoendosc Adv Surg Tech A, 2014; 24:693–697.
23.
RasmussenMS, JorgensenLN, Wille-JørgensenP, et al.Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: A multicenter randomized open-label study. J Thromb Haemost, 2006; 4:2384–2390.
24.
BergqvistD, AgnelliG, CohenAT, EldorA, NilssonPE, Le Moigne-AmraniA, Dietrich-Neto FEN, OXACAN IIInvestigators. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med, 2002; 346:975–980.
25.
WilsonTG, GuruK, RosenRC, et al.Best practices in robot-assisted radical cystectomy and urinary reconstruction: Recommendations of the Pasadena Consensus Panel. Eur Urol, 2015; 67:363–375.
26.
HusseinAA, SaarM, MayPR, et al.Early oncologic failure after robot-assisted radical cystectomy: Results from the International Robotic Cystectomy Consortium. J Urol, 2017; 197:1427–1436.
27.
DesaiMM, BergerAK, BrandinaRR, ZehnderP, SimmonsM, AronM, SkinnerEC, GillIS. Robotic and laparoscopic high extended pelvic lymph node dissection during radical cystectomy: Technique and outcomes. Eur Urol, 2012; 61:350–355.
28.
HellenthalNJ, HussainA, AndrewsPE, et al.Lymphadenectomy at the time of robot-assisted radical cystectomy: Results from the International Robotic Cystectomy Consortium. BJU Int, 2011; 107:642–646.
29.
LeissnerJ, GhoneimMA, Abol-EneinH, et al.Extended radical lymphadenectomy in patients with urothelial bladder cancer: Results of a prospective multicenter study. J Urol, 2004; 171:139–144.
