The application and use of robotics during radical cystectomy for the treatment of bladder cancer are still being defined.
Methods
A systematic literature search was conducted, with an emphasis on studies published within the previous 5 years. Areas of interest included patient selection, outcomes, cost, and comparisons of robotic-assisted radical cystectomy to open surgery.
Results
Although data are lacking in this field, using robotic assistance for radical cystectomy may lead to improvements in estimated blood loss, time to bowel activity, and reduced hospital stay; however, these improvements come at the cost of increased operative time and have a learning curve.
Conclusions
The widespread adoption of robotic-assisted radical cystectomy has not gained acceptance due to lack of evidence and clinical trials showing superiority over open surgery.
References
1.
BarbashG.I., GliedS.A.. New technology and health care costs–the case of robot-assisted surgery.N Engl J Med.2010; 363(8): 701–704.
YuH.Y., HeveloneN.D., LipsitzS.R.. Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample.Eur Urol.2012; 61(6): 1239–1244.
4.
SmithA.B., RaynorM., AmlingC.L.. 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.
5.
BochnerB.H., LaudoneV.P.; Memorial Sloan Kettering Cancer Center Bladder Cancer Surgical Trials Group. More on robot-assisted laparoscopic radical cystectomy.N Engl J Med.2014; 371(17): 1655.
6.
KhanM.S., ElhageO., ChallacombeB.. Long-term outcomes of robot-assisted radical cystectomy for bladder cancer.Eur Urol.2013; 64(2): 219–224.
7.
KaderA.K., RichardsK.A., KraneL.S.. Robot-assisted laparoscopic vs open radical cystectomy: comparison of complications and perioperative oncological outcomes in 200 patients.BJU Int.2013; 112(4): E290–E294.
8.
ButtZ.M., PerlmutterA.E., PiacenteP.M.. Impact of body mass index on robot-assisted radical cystectomy.JSLS.2008; 12(3): 241–245.
9.
NixJ., SmithA., KurpadR.. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results.Eur Urol.2010; 57(2): 196–201.
10.
ParekhD.J., MesserJ., FitzgeraldJ.. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy.J Urol.2013; 189(2): 474–479.
11.
StynN.R., MontgomeryJ.S., WoodD.P.. Matched comparison of robotic-assisted and open radical cystectomy.Urology.2012; 79(6): 1303–1308.
12.
StegemannA., RehmanS., BrewerK.. Short-term patient-reported quality of life after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation.Urology.2012; 79(6): 1274–1279.
13.
Al-DaghminA., AboumohamedA., DinR.. Readmission after robot-assisted radical cystectomy: outcomes and predictors at 90-day follow-up.Urology.2014; 83(2): 350–356.
14.
PruthiR.S., NielsenM.E., NixJ.. Robotic radical cystectomy for bladder cancer: surgical and pathological outcomes in 100 consecutive cases.J Urol.2010; 183(2): 510–514.
15.
HaynM.H., HellenthalN.J., HussainA.. Defining morbidity of robot-assisted radical cystectomy using a standardized reporting methodology.Eur Urol.2011; 59(2): 213–218.
16.
RaynorM.C., LavienG., NielsenM.. Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion.Urol Oncol.2013; 31(1): 32–35.
BochnerB.H., DalbagniG., SjobergD.D.. Comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: a randomized Clinical trial.Eur Urol.2015; 67(6): 1042–1050.
19.
KhanM.S., ChallacombeB., ElhageO.. A dual-centre, cohort comparison of open, laparoscopic and robotic-assisted radical cystectomy.Int J Clin Pract.2012; 66(7): 656–662.
20.
GuruK.A., WildingG.E., PiacenteP.. Robot-assisted radical cystectomy versus open radical cystectomy: assessment of postoperative pain.Can J Urol.2007; 14(6): 3753–3756.
21.
HaynM.H., HussainA., MansourA.M.. The learning curve of robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium.Eur Urol.2010; 58(2): 197–202.
22.
RichardsK.A., KaderA.K., OttoR.. Is robot-assisted radical cystectomy justified in the elderly? A comparison of robotic versus open radical cystectomy for bladder cancer in elderly ≥75 years old.J Endourol.2012; 26(10): 1301–1306.
23.
Karen PazG.E., LaudoneV.P., BochnerB.H.. Does minimally invasive surgery for radical cystectomy provide similar long-term cancer control as open radical surgery?Curr Opin Urol.2013; 23(5): 449–455.
24.
DavisJ.W., GastonK., AndersonR.. Robot assisted extended pelvic lymphadenectomy at radical cystectomy: lymph node yield compared with second look open dissection.J Urol.2011; 185(1): 79–83.
25.
AbazaR., DangleP.P., GongM.C., BahnsonR.R., PoharK.S.. Quality of lymphadenectomy is equivalent with robotic and open cystectomy using an extended template.J Urol.2012; 187(4): 1200–1204.
26.
HollenbeckB.K., DunnR.L., WolfJ.S.. Development and validation of the convalescence and recovery evaluation (CARE) for measuring quality of life after surgery.Qual Life Res.2008; 17(6): 915–926.
27.
HautmannR.E., HerrH.W., PruthiR.S.. Robotic radical cystectomy – is the diversion the Achilles’ heel?J Urol.2014; 192(6): 1601–1603.
28.
JonssonM.N., AddingL.C., HosseiniA.. Robot-assisted radical cystectomy with intracorporeal urinary diversion in patients with transitional cell carcinoma of the bladder.Eur Urol.2011; 60(5): 1066–1073.
29.
CandaA.E., AtmacaA.F., AltinovaS.. 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; 110(3): 434–444.
30.
LeeR., ChughtaiB., HermanM.. Cost-analysis comparison of robot-assisted laparoscopic radical cystectomy (RC) vs open RC.BJU Int.2011; 108 (6 pt 2): 976–983.
31.
RichardsK.A., KaderK., PettusJ.A.. Does initial learning curve compromise outcomes for robot-assisted radical cystectomy? A critical evaluation of the first 60 cases while establishing a robotics program.J Endourol.2011; 25(9): 1553–1558.
32.
HaynM.H., HellenthalN.J., Seixas-MikelusS.A.. Is patient outcome compromised during the initial experience with robot-assisted radical cystectomy? Results of 164 consecutive cases.BJU Int.2011; 108(6): 882–887.
33.
SmithN.D., CastleE.P., GonzalgoM.L.. The RAZOR (randomized open vs robotic cystectomy) trial: study design and trial update.BJU Int.2015; 115(2): 198–205.
