V10-12: Robotic Bladder Neck Closure and Mitrofanoff
Complex urologic reconstruction may be required after morbid cancer operations. Well documented advantages of robotic surgery can be utilized during these reconstructive cases including shorter hospital stay and improved cosmesis. This video demonstrates a robotic bladder neck closure and appendicovesicostomy after radical vaginectomy and urethrectomy in a female with vulvar melanoma.
Our patient is a 72 year old female with vulvar melanoma requiring a radical vaginectomy, urethrectomy and inguinal node dissection by the gynecologists. We performed a concomitant robotic bladder neck closure and Mitrofanoff catheterizable channel.
Operative time was 368 minutes, of which 204 minutes was robotic time. Estimated blood loss was 200 mL. The patient had an uncomplicated hospital course and was discharged on post-operative day #3. Three weeks after surgery she was taught to catheterize her Mitrofanoff. She is doing well 4 months after surgery without evidence of disease or incontinence.
Robotic bladder neck closure and Mitrofanoff are safe and effective means to treat patients after morbid vaginal cancer operations. It offered this patient continence while providing quick recovery and optimal cosmesis.