Robot-assisted radical cystectomy in women: Technique and initial experience

Background and Purpose: Robot-assisted radical cystectomy (RARC) is a new management option for the treatment of bladder cancer. This study evaluates an initial experience with RARC with ileal conduit diversion in women. Patients and Methods: Twenty patients underwent RARC with ileal conduit urinary diversion, including four women, and our surgical technique is described here. A retrospective chart review was performed to evaluate clinical stage, tumor grade, operative times, estimated blood loss (EBL), pathologic stage, lymph node pathology, and complications. Results: Mean patient age was 69.5 years, median operative time was 350 minutes, and median EBL was 300 mL. Median length of stay was 5 days, with the two most recent patients leaving by postoperative day 3. The median number of lymph nodes removed was 12, with one patient revealing node-positive disease. Surgical margins were negative for disease in all patients. No patients required blood transfusion or had major complications. Conclusion: RARC is a new technique available for the treatment of high-risk or invasive bladder cancer in women. This surgery provides decreased morbidity while maintaining the oncologic goals of traditional radical cystectomy.