Robot-Assisted Cystectomy: Strengths and Weaknesses

Andrea Gallina, Nazareno Suardi, Peter Schatteman, Geert de Naeyer, Paul Carpenter, Alexandre Mottrie

Research output: Contribution to journalArticle

Abstract

Introduction: In recent years, minimally invasive techniques such as purely robot-assisted radical cystectomy (RARC) have been suggested as a new surgical approach to muscle-invasive bladder cancer. In this article we review the review the intra- and perioperative results as well as the short- and intermediate-term oncologic results of RARC. Materials and methods: Based on the work recently presented at the European Society of Oncological Urology's 2011 meeting, we reviewed the available literature on RARC. A PubMed literature search was conducted in March 2011 to review English-language articles published from 2000 onward on RARC. Results: The literature supports that lymph node yield, learning curve, and intermediate-term oncologic outcomes related to RARC are not different from open surgery. Several articles described the advantages of robotic approach in terms of estimated blood loss, hospital stay, and perioperative outcomes. Operative time remains significantly longer than in the open procedure. A low rate of positive surgical margins may be achieved with RARC, comparable with the open approach. Intracorporeal urinary diversion is likely to represent the future direction for RARC, even if it requires great technical expertise. Due to the relatively recent introduction of the robotic approach in the bladder cancer arena, long-term oncologic data are not yet available. Conclusions: RARC represents a safe and viable treatment for muscle-invasive bladder cancer. However, there is an urgent need for large, prospective, randomised trials that will establish the potential advantages and limitation of RARC compared with the open approach. Robot-assisted radical cystectomy represents a safe treatment for muscle-invasive bladder cancer that may offer several potential advantages compared with open cystectomy, without compromising cancer control.

Original languageEnglish
JournalEuropean Urology, Supplements
Volume10
Issue number3
DOIs
Publication statusPublished - May 2011

Keywords

  • Cancer control
  • Learning curve
  • Pelvic lymphadenectomy
  • Robot-assisted laparoscopic radical cystectomy
  • Surgical margins

ASJC Scopus subject areas

  • Urology

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    Gallina, A., Suardi, N., Schatteman, P., de Naeyer, G., Carpenter, P., & Mottrie, A. (2011). Robot-Assisted Cystectomy: Strengths and Weaknesses. European Urology, Supplements, 10(3). https://doi.org/10.1016/j.eursup.2011.04.002