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Keywords:

  • radical cystectomy;
  • robot;
  • bladder neoplasm;
  • urothelial carcinoma;
  • outcomes

What's known on the subject? and What does the study add?

Robot-assisted radical cystectomy is an increasingly used method for surgical extirpation for clinically localized, muscle-invasive urothelial cartinoma. This study reviews its technique and associated preoperative and oncological outcomes.

OBJECTIVE

  • • 
    To assess peri-and postoperative outcomes of robot-assisted radical cystectomy (RARC) with pelvic lymph node dissection (PLND) and urinary diversion for the treatment of bladder cancer.

MATERIALS AND METHODS

  • • 
    We review our previously described surgical technique for RARC and its development over recent years, with an accompanied video illustration.
  • • 
    We also focus on peri- and postoperative outcomes of RARC and compare this with the ‘gold standard’ of open RC.

RESULTS

  • • 
    RARC has been steadily growing since 2003, with acceptable peri-and postoperative outcomes.
  • • 
    Most studies report decreased blood loss, return of bowel function, and shorter length of hospital stay. Furthermore, complication rates have been shown to be similar to that of open series.
  • • 
    Most importantly, oncological outcomes appear to be favourable in terms of margin status, LND and disease-specific survival, although data may be affected by the lack of long-term results and a randomized clinical trial assessing overall survival.

CONCLUSIONS

  • • 
    RARC with PLND and urinary diversion is an increasingly used strategy in the treatment armamentarium for bladder cancer.
  • • 
    Perioperative and oncological outcomes from existing data have been favourable thus far, but are limited by relatively short follow-up.
  • • 
    Randomized clinical trials with extended patient follow-up are needed to fully assess outcomes related to RARC.