V12-10: Robot-assisted Laparoscopic Radical Cystectomy and Intracorporeal Neobladder Utilizing a Vaginal-Sparing and Staple-Free Approach
At our institution robot assisted laparoscopy with intracorporeal neobladder has become standard of care for our treatment of patients with muscle invasive bladder cancer. When indicated and feasible we perform a vaginal sparing and staple-free approach for our female patients in order to optimize continence and sexual function.
Using a high definition recording system and iMovie software with narrative and annotative editing we created a video illustrating our vaginal-sparing and staple-free approach to the robot assisted laparoscopic radical cystectomy and neobladder. Our Patient is a 66 year old female with high grade bulky urothelial carcinoma of the bladder.
We have performed vaginal-sparing and staple-free robot-assisted laparoscopic radical cystectomy and intracorporeal neobladder in 12 patients. Patients age range of 41-72 years old. 70% of these patients underwent neoadjuvant chemotherapy. Total operative times range from 4.25 – 5.85 hours. The majority of patients have self-reported good satisfaction with neobladder after surgery.
In our experience, the robotic staple-free, vaginal-sparing intracorporeal neobladder is a safe and effective method of treatment for muscle invasive bladder cancer. Long term cancer control not yet proven with the robotic approach; however short term control is comparable to other methods. Further study will be needed to demonstrate the long term safely and cancer control with this technique.