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Robotic Surgery of the Bladder pp 77–91Cite as

Variations in Surgical Approach: Partial Cystectomy, Vaginal-Sparing, and Prostate-Sparing

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Abstract

Radical cystectomy, considered to be the most effective treatment method for localized muscle-invasive disease as well as refractory cases of high grade, non-muscle-invasive transitional cell carcinoma or carcinoma in situ, is a highly morbid procedure and has been known to adversely impact both urinary and sexual functions. To minimize these side effects without compromising oncological efficacy, strategies such as partial cystectomy (PC), vaginal-sparing radical cystectomy (VSRC), and prostate-sparing radical cystectomy (PSRC) have evolved. While these approaches may not be appropriate for all patients, many contemporary series have reported superior urinary continence and potency rates in addition to comparable oncological outcomes in carefully selected group of patients. In this chapter, we seek to present the indications and techniques of these surgical variations on robot-assisted laparoscopic cystoprostatectomies and anterior pelvic exenterations.

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Acknowledgments

Special thanks to Mani Menon, James O. Peabody, Quoc-Dinh Trinh, Jesse Sammon, Shyam Sukumar, Sanjeev Kaul, Sumit De, and Ali Dabaja for the making of prostate-sparing cystectomy video and Manish N. Patel and L. Spencer Krane for the making of partial-cystectomy video.

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Authors and Affiliations

  1. Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Bethesda, MD, 20892, USA

    Anthony N. Hoang & Piyush K. Agarwal M.D.

  2. Wake Forest Baptist Health, Winston-Salem, NC, 27157, USA

    Ashok K. Hemal

  3. Urologic Oncology Branch, National Cancer Institute, National Institute of Health, Building 10 – CRC, Room 2-5952, 10 Center Drive, MSC 1210, Bethesda, MD, 20892-1210, USA

    Piyush K. Agarwal M.D.

Authors
  1. Anthony N. Hoang
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  2. Ashok K. Hemal
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  3. Piyush K. Agarwal M.D.
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Correspondence to Piyush K. Agarwal M.D. .

Editor information

Editors and Affiliations

  1. Department of Urology, Mayo Clinic, Phoenix, Arizona, USA

    Erik P. Castle

  2. Department of Urology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Raj S. Pruthi

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Hoang, A.N., Hemal, A.K., Agarwal, P.K. (2014). Variations in Surgical Approach: Partial Cystectomy, Vaginal-Sparing, and Prostate-Sparing. In: Castle, E., Pruthi, R. (eds) Robotic Surgery of the Bladder. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4906-5_8

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  • DOI: https://doi.org/10.1007/978-1-4614-4906-5_8

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  • Online ISBN: 978-1-4614-4906-5

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