Division of Urologic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Recent small case series have now been reported for robotic-assisted laparoscopic radical cystectomy. Herein, we describe our approach and initial experience with robotic-assisted laparoscopic anterior pelvic exenteration in the female patient with bladder cancer.

We describe the technique of robotic-assisted laparoscopic anterior pelvic exenteration. The classic da Vinci((R)) or the da Vinci S() robotic platform is utilized for the procedure. In our experience, 12 women underwent robotic-assisted laparoscopic anterior pelvic exenteration and extracorporeal urinary diversion for clinically localized bladder cancer.

Mean age was 67.9 years (range 61-79 years). Nine patients underwent ileal conduit diversion and three patients underwent an orthotopic neobladder. In all cases, the urinary diversion was performed extracorporeally. Mean operating room time was 4.6 h; mean surgical blood loss was 221 mL. On surgical pathology, seven patients were =pT2, three patients were pT3, and two patients were N+. In no case was there positive surgical margins, and in one case there was inadvertent entry into the bladder. Mean number of lymph nodes removed was 19 (range 12-34). Mean time to flatus was 1.9 days and to bowel movement 2.4 days, and time to discharge 4.8 days. Six patients were discharged on postoperative day 4, four patients on postoperative day 5, one on postoperative day 6, and one on postoperative day 8. There were two postoperative complications (17%) in two patients.

Our initial experience with robotic-assisted laparoscopic anterior pelvic exenteration appears to be favorable with acceptable operative, pathologic, and short-term clinical outcomes. Certainly, larger experiences are required to adequately evaluate and validate this procedure as an appropriate surgical and oncologic option.

Written by
Pruthi RS, Stefaniak H, Hubbard JS, Wallen EM.

Reference
J Endourol. 2008 Jul 11. Epub ahead of print.

PubMed Abstract
PMID:18620501

UroToday.com Bladder Cancer Section

Please log-in or register in order to submit comments.

Powered by AkoComment!