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The 10 th Catholic International Urology Symposium, 2008 13:30–14:50 Asian experiences of laparoscopic radical cystectomy. Robot-assisted Laparoscopic Radical Cystectomy. KH Rha Severance Hospital Yonsei University. Robot-assisted Laparoscopic Radical Cystectomy. Advantages - PowerPoint PPT Presentation
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Robot-assisted Laparoscopic Radical
Cystectomy
KH RhaSeverance HospitalYonsei University
The 10th Catholic International Urology Symposium, 2008
13:30–14:50 Asian experiences of laparoscopic radical cystectomy
Robot-assisted Laparoscopic Radical Cystectomy
Advantages• surgeon comfort• less learning curve (than lap surgery)• advantages of minimally invasive surgery • better outcome?
Disadvantages• lack of an effective force-feedback feature • more cumbersome robotic installation • relative high cost
• Between April 2007 and April 2008 • 6 men, 3 women• RLRC were performed with the da Vinci™ robot
system with four robot arms. • The specimen was extracted through the
subumbilical incision. • The ICUD was achieved through a removal site
of a specimen by extracorporeal technique.
Robot-assisted Laparoscopic Radical Cystectomy in Yonsei
17cm
8cm8cm8cm
8cm
8cm
● 5mm port
■ 8mm port
▲ 12mm port
2-3cm
Port Placement
Robot-assisted Laparoscopic Radical Cystectomy in Yonsei
Results • Mean operative time: 379.8 ± 77.8 min• Mean estimated blood loss: 611.1 ± 431.4 ml• No major intraoperative complication• One open conversion due to severe adhesion
Robot-assisted Laparoscopic Radical Cystectomy in Yonsei
Robot-assisted Laparoscopic Radical Cystectomy in Yonsei
Pathologic stage Number of patientsPositive
Margins
T0/Ta/Tis 3 -
T1/T2 3 -
T3 1 -
T4 2 -
Results • Mean number of LN dissected: 16.4 ± 7.7
(range: 12–28)• Mean hospital stay: 10.3 ± 2.8 days• Mean soft diet start: 5.4 ± 1.7 days
Robot-assisted Laparoscopic Radical Cystectomy in Yonsei
• Robot-assisted radical cystectomy with pelvic lymph node dissection can be safely performed in patients who are candidates for open cystectomy• Long term oncological results and QOL outcomes will define its position in minimally invasive urologic oncology
Conclusion
Thank you for attention.
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