Robotic assisted laparoscopic radical cystectomy for bladder carcinoma: Early experience and oncologic outcomes

Aims: Robot-assisted radical cystectomy (RARC) has been a popular mode of therapy in the treatment of bladder carcinoma for several years, and its usage in bladder carcinoma patients is on the rise. We evaluated the usefulness of this mode of therapy by studying the clinical outcomes following RARC for the treatment of bladder carcinoma. Methods: From 2006 to 2011, a total of eight patients in our hospital who underwent RARC for bladder carcinomas were enrolled in this study. Clinical outcomes were measured by means of preoperative status, operative strategy and initial outcomes. Results: Follow-up ranged from 4 to 22 months (mean 10.9 months). The mean operative time was 430.3 minutes, and the operative time decreased with the increasing experience of the surgeon and assistants. The mean estimated blood loss was 762.5 mL. The surgical approach was RARC and orthotopic ileal neobladder in five patients (62.5%), bilateral nephrectomy with RARC in two patients (25%), and RARC with ileal conduit alone in one patient (12.5%). Histological examination showed five instances of stage pT1 tumor, one pT2 tumor, and two instances of original tumor with extravesical disease (pT3b). One patient had lymph node involvement. Postoperative complications included urethral stricture in one case and vesicovaginal fistula in another. The mean hospital stay was 10.8 days (range 7-26 days). None of the patients had a positive surgical margin. There was no surgical mortality in this series. Conclusion: RARC is a challenging but safe and minimally-invasive method of treating bladder carcinoma.