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.