NARUS 2018: What's New in Robotic Intracorporeal Urinary Diversion

Las Vegas, NV (UroToday.com) Dr. Goh gave a talk on the status of intracorporeal urinary diversion (IUD). Robotic cystectomy (RARC) utilization has grown over more than a decade (0.06% in 2004 to 39% in 2013). Most centers still perform extracorporeal diversion. IUD is technically challenging, time consuming, and can lead to significant complications. Reports of IUD utilization range from 3%-18%.

IUD can actually help with recovery. It decreases insensible losses and wound morbidity. It also decreases pain medication requirements and leads to quicker return of bowel function. Level 1 evidence demonstrates that there is no difference in complication rate between RARC with IUD and open cystectomy.

The key factors when creating an IUD include bowel segmentation, bowel anastomosis, bowel reconstruction, and ureteral anastomosis. RARC and IUD is feasible and safe with experienced robotic surgeons. The full range of urinary diversion can be performed by intracorporeal approach. IUD may improve recovery and reduce certain complications. It lowers usage of analgesics, and reduces the rates of gastrointestinal, infectious and wound complications. The technical skills required for IUD are additive and broaden surgical versatility. However, long term functional outcomes need prospective evaluation.

Speaker: Alvin Goh, Memorial Sloan Kettering Cancer Center, NY, USA

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV