V1890: Robot-assisted partial cystectomy for bladder cancer of a bladder diverticulum

Video

Introduction and Objectives
The incidence of bladder diverticula is 1.7%, while the incidence of urothelial carcinoma within these diverticula ranges from 0.8 to 13%. In this video, we report our technique of robot-assisted partial cystectomy for urothelial cancer located within a bladder diverticulum.

Methods
Our patient was a 64 year-old male who presented with a history of prostate cancer on active surveillance. He underwent a cystoscopy for increasing post-void residual, which revealed an incidental bladder tumor within a diverticulum. This tumor turned out to be a high-grade pTa lesion. A transperitoneal robot-assisted laparoscopic approach was used to mobilize the bladder. The bladder lesion was marked with a hook cautery circumferentially. Simultaneous cystoscopic monitoring was performed to ensure a margin of resection of 2 cm around the lesion. Bladder reconstruction and bilateral pelvic lymph node dissection were subsequently completed.

Results
Our console time was 5 hours with an estimated blood loss of 50 mL. No JP drain was placed. There were no intra or post-operative complications. Diet was resumed on postoperative day 1 and the patient was discharged on postoperative day 1. Pathological examination revealed an urothelial carcinoma pTaN0Mx with low grade and negative surgical margins. He is doing well with no sign of recurrence at three months of follow-up.

Conclusions
Robot-assisted laparoscopic partial cystectomy is technically feasible and represents an alternative to open and conventional laparoscopic approaches.

Funding: none