Robotic Radical Perineal Cystectomy And Extended Pelvic Lymphadenectomy: Initial Investigation Using A Purpose-Built Single-Port Robotic System

To assess the feasibility of perineal radical cystoprostatectomy using the latest generation purpose-built single-port robotic surgical system.

In two male cadavers, the da Vinci SP1098 Surgical System was used to perform radical cystoprostatectomy and bilateral extended pelvic lymphadenectomy. New features in this model include enhanced high-definition three-dimensional optics, improved instrument maneuverability, and a real-time instrument tracking and guideance system. The surgery was accomplished through a 3-cm perineal incision via a novel robotic single-port system, which accomodates three double-jointed articulating robotic instruments, an articulating camera, and an accessory laparoscopic instrument. The primary outcomes were technical feasibility, intraoperative complications, and total robotic operative time.

The cases were completed successfully without conversion. There were no accidental punctures or lacerations. The robotic operative times were 197 and 202 minutes.

In this preclinical model, robotic radical perineal cystoprostatectomy and extended pelvic lympadenectomy was feasible using the SP1098 robotic platform. Further investigation is needed to assess the feasibility of urinary diversion using this novel approach and new technology. This article is protected by copyright. All rights reserved.

BJU international. 2017 Jul 03 [Epub ahead of print]

Matthew J Maurice, Jeremy Reese, Jihad H Kaouk

Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.