Robot-assisted laparoscopic vs open radical cystectomy: comparison of complications and perioperative oncological outcomes in 200 patients


Correspondence: Ashok K. Hemal, Wake Forest University, Medical Center Blvd., Winston-Salem, NC 27157, USA.




  • To compare perioperative morbidity and oncological outcomes of robot-assisted laparoscopic radical cystectomy (RARC) to open RC (ORC) at a single institution.

Patients and Methods

  • A retrospective analysis was performed on a consecutive series of patients undergoing RC (100 RARC and 100 ORC) at Wake Forest University with curative intent from 2006 until 2010.
  • Complication data using the Clavien system were collected for 90 days postoperatively.
  • Complications and other perioperative outcomes were compared between patient groups.


  • Patients in both groups had comparable preoperative characteristics.
  • The overall and major complication (Clavien ≥3) rates were lower for RARC patients at 35 vs 57% (P = 0.001) and 10 vs 22% (P = 0.019), respectively.
  • There were no significant differences between groups for pathological outcomes, including stage, number of nodes harvested or positive margin rates.


  • Our data suggest that patients undergoing RARC have perioperative oncological outcomes comparable with ORC, with fewer overall or major complications.
  • Definitive claims about comparative outcomes with RARC require results from larger, randomised controlled trials.