V13-08 ROBOTIC INTRACORPOREAL ORTHOTOPIC ILEAL NEOBLADDER: REPLICATING OPEN SURGICAL PRINCIPLES OF Y-SHAPED TECHNIQUE

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You have accessJournal of UrologyBladder & Upper Tract Urothelial Oncology (V13)1 Sep 2021V13-08 ROBOTIC INTRACORPOREAL ORTHOTOPIC ILEAL NEOBLADDER: REPLICATING OPEN SURGICAL PRINCIPLES OF Y-SHAPED TECHNIQUE Tommaso Silvestri, Federico Germinale, Giovanni Costa, Bernardino De Concilio, Guglielmo Zeccolini, Giorgio Mazzon, and Antonio Celia Tommaso SilvestriTommaso Silvestri More articles by this author , Federico GerminaleFederico Germinale More articles by this author , Giovanni CostaGiovanni Costa More articles by this author , Bernardino De ConcilioBernardino De Concilio More articles by this author , Guglielmo ZeccoliniGuglielmo Zeccolini More articles by this author , Giorgio MazzonGiorgio Mazzon More articles by this author , and Antonio CeliaAntonio Celia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002100.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancer is the fourth most common cancer diagnosed in men in the Europe and currently radical cystectomy is yet the gold-standard treatment in patient fit for surgery. In the last five years, there was a progressively evolution in robotic technique for ileal neobladder. Herein, we describe our step-by-step technique for robotic intracorporeal neobladder formation. METHODS: We present the case of a 59 years old patient with a diagnosis of an muscular-invasive bladder cancer underwent neoadjuvant chemotherapy and then radical cystectomy and super-extended bilateral pelvic lymphadenectomy. The presented video is a focus on our approach and technique for the configuration of the Y-shaped neobladder. The main surgical steps to forming the intracorporeal orthotopic ileal neobladder are: isolation of 45 cm of small bowel (length varies in relation to the characteristics of ileum); neobladder-urethral anastomosis; small bowel anastomosis; bowel detubularisation; suture of the posterior wall of the neobladder; and cross folding of the pouch; and uretero-enteral anastomosis. Improvements have been made to these steps to enhance time efficiency without compromising neobladder configuration. RESULTS: From January 2017 to July 2020 we performed our technique in 25 patients. Our technical improvements have resulted in a decreasing in operative time from 400 to 200 min. Postoperative surgical complications occurred in four of the 18 patients (22.1%), including one surgical Clavien-Dindo Grade III and three Grade I, postoperative medical Clavien-Dindo Grade II complications occurred in three (16.7%) patients. On urodynamic examination (available in 5 [20%] patients) the median (IQR) reservoir cystometric capacity, compliance, and post-void residual were 220 (190-256) mL, 17 (11.8-20.1) mL/cmH2 O, and 0 (0-56) mL, respectively. CONCLUSIONS: We describe our step-by-step technique of robot-assisted intracorporeal orthotopic ileal neobladder formation. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1080-e1080 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tommaso Silvestri More articles by this author Federico Germinale More articles by this author Giovanni Costa More articles by this author Bernardino De Concilio More articles by this author Guglielmo Zeccolini More articles by this author Giorgio Mazzon More articles by this author Antonio Celia More articles by this author Expand All Advertisement Loading ...

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