V1888: USC Technique for Robot-assisted Intracorporeal Studer Neobladder

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Introduction and Objectives
Several minimally invasive approaches for modified intracorporeal ileal neobladder have been described in the literature. In an effort to improve efficiency and decrease operative time, several modifications have been employed including the use of laparoscopic stapling. Unlike open orthotopic neobladder, there is limited functional data available for these techniques.

Methods
We present a novel technique for robot-assisted completely intracorporeal Studer neobladder, which replicates precisely the principles of the open procedure. A standard 6-port robotic cystectomy configuration is applied. In our technique, we incorporate 1) consistent small bowel dimensions, 2) hand-sewn reconstruction, 3) neobladder configuration reflecting the Studer description, 4) dependent urethral anastomosis, 5) an isoperistaltic afferent limb, and 6) stented ureteroileal anastomoses.

Results
The operative time for the demonstrated case is summarized in Table 1. Our initial experience with robot-assisted intracorporeal urinary diversion is summarized in Table 2.

Conclusions
We demonstrate a novel technique for robot-assisted intracorporeal Studer neobladder adhering to the principles of the open procedure. Cumulative experience has improved efficiency and helped to optimize our technique. Further investigation is needed to evaluate functional and oncologic outcomes.

Funding: none