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Robotically Assisted Radical Cystectomy

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Minimally Invasive Urology

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Abstract

Robotically assisted radical cystectomy (RARC) is an exciting application of the robotic surgical platform whose role in future surgery is still being determined. Open radical cystectomy (ORC) as currently practiced is an effective although underutilized and significantly morbid procedure, with complication rates exceeding 60 % when strictly reported. Many different outcomes have been reported regarding potential benefits and costs with the robotically assisted approach, but at this point two factors have been consistently shown: blood loss is lower, and OR times are longer for RARC as compared to ORC. In some centers, outcomes and length of stay appear to favor the robotic approach, but in other centers of excellence, no benefit has been demonstrated when compared with well-executed, high-volume open cystectomy. That said, we are aware of no recent series that shows RARC to result in inferior oncologic or quality-associated outcomes such as length of stay or complication rate when compared to ORC. Costs are largely associated with avoidance of complications; as familiarity grows and technique is refined, the benefits of lower blood loss and decreased fluid shifts may ultimately result in measurably better outcomes and lower overall cost.

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Authors and Affiliations

  1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Third Floor, 1685 Highland Avenue, Madison, WI, 53705, USA

    Granville L. Lloyd MD, E. Jason Abel & Tracy M. Downs

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  1. Granville L. Lloyd MD
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  2. E. Jason Abel
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  3. Tracy M. Downs
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Correspondence to Granville L. Lloyd MD .

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Editors and Affiliations

  1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

    Sara L. Best

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

    Stephen Y. Nakada

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Lloyd, G.L., Abel, E.J., Downs, T.M. (2015). Robotically Assisted Radical Cystectomy. In: Best, S., Nakada, S. (eds) Minimally Invasive Urology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1317-6_7

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  • DOI: https://doi.org/10.1007/978-1-4939-1317-6_7

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