V12-05: Revisiting the Abdomen after Robot-Assisted Radical Cystectomy: Tips and Tricks for Robot-Assisted Repair

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INTRODUCTION

Reoperations following robot-assisted radical cystectomy (RARC) are challenging owing to technical complexity (abdominal adhesions and altered anatomy after cystectomy). We sought to describe our experience in robot-assisted (RA) reoperations following RARC.

METHODS

We retrospectively review 406 RARCs performed by a single surgeon between 2005 and 2015. Data were reviewed for demographics, preoperative disease, and operative and perioperative outcomes. Surgical interventions for RARC-specific complications were identified and RA technique described.

RESULTS

For ureteroileal complications: 12 RA versus 7 open. Both had comparable perioperative outcomes. Fistula repair: 5 RA versus 6 open. Although patients in the RA group had longer operative times, they had shorter hospital stay (4 versus 10 days) and none of them required further intervention (4 in the open group did). Bowel obstruction that failed conservative treatment: 4 RA versus 7 open. Further intervention was required in 2 patients in the RA. Parastomal hernia repair: 4 RA and 2 open (one failed).

CONCLUSION

Our initial experience with RA management of RARC complications appears safe and feasible, although the decision to proceed is determined primarily by surgeon experience.

Funding: Roswell Park Alliance Foundation