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Review Article

Robot-Assisted Laparoscopic Radical Cystectomy

Kwang Hyun Kim, Dong Hyeon Lee
The Ewha Medical Journal 2014;37(1):10-15. Published online: March 25, 2014

Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Dong Hyeon Lee. Department of Urology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-5157, Fax: 82-2-2654-3682, leedohn@ewha.ac.kr
• Received: February 8, 2014   • Accepted: February 17, 2014

Copyright © 2014. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Robot-assisted laparoscopic radical cystectomy (RARC) for the treatment of muscle invasive bladder cancer is being increasingly applied. Radical cystectomy is complex procedure which should be performed with extensive lymph node dissection and urinary diversion. Currently, the techniques of RARC are well-described, and the feasibility and safety of RARC has been demonstrated. While extracorporeal approach is preferred method for urinary diversion, intracorporeal urinary diversion is gaining popularity. Positive surgical margins are similar to large open series but inferior for locally advanced disease. However, local recurrence and survival rates seem equivalent to open series at short and mid-term follow up. Randomized controlled trial should be conducted to rigorously assess the oncologic outcomes of RARC compared to open radical cystectomy.
  • Keywords: Urinary bladder neoplasms; Cystectomy; Robotics; Surgical procedures, minimal invasive
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Fig. 1
Port placement. Six port placement is used for robot assisted laparoscopic radical cystectomy.
emj-37-10-g001.jpg
Fig. 2
Mobilization of ureter. Left ureter is mobilized up to ureterovesical junction preserving periureteral vascularity. U, ureter; B, urinary bladder.
emj-37-10-g002.jpg
Fig. 3
Posterior dissection. The plane between posterior aspect of prostate and rectum is developed following peritoneotomy of Douglas pouch. P, prostate; R, rectum.
emj-37-10-g003.jpg
Fig. 4
Lateral dissection. Right superior vesical artery is ligated using hemoclip.
emj-37-10-g004.jpg
Fig. 5
Anterior dissection. The bladder is mobilized off the anterior abdominal wall and pubic bone by an incision of anterior peritoneum including the urachus. P, pubic bone; B, urinary bladder.
emj-37-10-g005.jpg
Fig. 6
Pelvic lymph node dissection. Left lymph node dissection is performed. E, external iliac artery; I, internal iliac artery; O, obturator nerve.
emj-37-10-g006.jpg

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      Robot-Assisted Laparoscopic Radical Cystectomy
      Ewha Med J. 2014;37(1):10-15.   Published online March 25, 2014
      DOI: https://doi.org/10.12771/emj.2014.37.1.10
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      Robot-Assisted Laparoscopic Radical Cystectomy
      Ewha Med J. 2014;37(1):10-15.   Published online March 25, 2014
      DOI: https://doi.org/10.12771/emj.2014.37.1.10
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      Robot-Assisted Laparoscopic Radical Cystectomy
      Image Image Image Image Image Image
      Fig. 1 Port placement. Six port placement is used for robot assisted laparoscopic radical cystectomy.
      Fig. 2 Mobilization of ureter. Left ureter is mobilized up to ureterovesical junction preserving periureteral vascularity. U, ureter; B, urinary bladder.
      Fig. 3 Posterior dissection. The plane between posterior aspect of prostate and rectum is developed following peritoneotomy of Douglas pouch. P, prostate; R, rectum.
      Fig. 4 Lateral dissection. Right superior vesical artery is ligated using hemoclip.
      Fig. 5 Anterior dissection. The bladder is mobilized off the anterior abdominal wall and pubic bone by an incision of anterior peritoneum including the urachus. P, pubic bone; B, urinary bladder.
      Fig. 6 Pelvic lymph node dissection. Left lymph node dissection is performed. E, external iliac artery; I, internal iliac artery; O, obturator nerve.

      Fig. 1

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      Fig. 3

      Fig. 4

      Fig. 5

      Fig. 6

      Robot-Assisted Laparoscopic Radical Cystectomy
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