Peri-Operative Outcomes after Open and Robot-Assisted Radical Cystectomy by Using an Advanced Bipolar Seal and Cut Technology (Caiman®): A Prospective, Comparative, and Multi-Institutional Study.

To report and compare the peri-operative outcomes of patients undergoing open (ORC) and robotic-assisted radical cystectomy (RARC) for bladder cancer performed with a radiofrequency seal and cut device (Caiman®).

Data of patients undergoing ORC or RARC between January 2015 and March 2016 at 6 Italian institutions were prospectively recorded and analyzed. Thirty-and 90-day complications were stratified according to the Martin's criteria and graded according to the Clavien-Dindo classification. Data on operative time, blood loss, transfusion rate, complications, and length of stay were evaluated and compared between the ORC and RARC groups.

Thirty-three (66%) and 17 (34%) patients were treated with ORC and RARC, respectively. The median age was 72 (64-78) years. Overall operative time was longer in RARC compared to ORC (389 ± 80.1 vs. 242 ± 62.2 min, p < 0.001), while the estimated blood loss during cystectomy was higher after ORC (370 ± 126.8 vs. 243.3 ± 201.6 ml, p = 0.03). The transfusion rate was significantly higher in the ORC compared to RARC (24.2 vs. 5.9%, p = 0.04). Eight (19%) and 7 (16.7%) patients experienced 30- and 90-day post-operative complications, with no significant difference between ORC and RARC. Length of stay was significantly shorter in RARC group (median 7 vs. 14 days, p < 0.001).

Open and robot-assisted procedures were safely performed by using a new advanced bipolar seal and cut technology (Caiman®). RARC demonstrated to be superior to ORC in terms of bleeding, transfusion rates and length of hospital stay, despite longer operative time.

Current urology. 2019 Mar 08 [Epub]

Marco Borghesi, Riccardo Schiavina, Alessandro Antonelli, Carlo Buizza, Antonio Celia, Paolo Parma, Bernardino De Concilio, Francesco Mengoni, Daniele Romagnoli, Giacomo Saraceni, Eugenio Brunocilla, Angelo Porreca

Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna., Department of Urology, University of Brescia, Spedali Civili, Brescia., Department of Urology, Ospedale di Circolo, Busto Arsizio., Department of Urology, San Bassiano Hospital, Bassano del Grappa., Department of Urology, Carlo Poma Hospital, Mantova., Department of Urology, Policlinino Abano Terme, Abano Terme, Italy.