Robotic Intracorporeal Continent Cutaneous Diversion

No AccessJournal of UrologyNew Technology and Techniques1 Aug 2017Robotic Intracorporeal Continent Cutaneous Diversion Mihir M. Desai, Giuseppe Simone, Andre Luis de Castro Abreu, Sameer Chopra, Mariaconsiglia Ferriero, Salvatore Guaglianone, Francesco Minisola, Daniel Park, Rene Sotelo, Michele Gallucci, Inderbir S. Gill, and Monish Aron Mihir M. DesaiMihir M. Desai More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Andre Luis de Castro AbreuAndre Luis de Castro Abreu More articles by this author , Sameer ChopraSameer Chopra More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Francesco MinisolaFrancesco Minisola More articles by this author , Daniel ParkDaniel Park More articles by this author , Rene SoteloRene Sotelo More articles by this author , Michele GallucciMichele Gallucci More articles by this author , Inderbir S. GillInderbir S. Gill More articles by this author , and Monish AronMonish Aron More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.01.091AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Robotic intracorporeal urinary diversion has mostly been done for ileal conduit or orthotopic neobladder diversion. We present what is to our knowledge the initial series, detailed technique and outcomes of the robotic intracorporeal Indiana pouch with a minimum 1-year followup. Materials and Methods: Ten patients underwent robotic radical cystectomy, pelvic lymphadenectomy and intracorporeal Indiana pouch urinary diversion for cancer in 9 and benign disease in 1. Data were collected prospectively. Baseline demographics, pathology data, and 1-year complication rates and functional outcomes were assessed. Results: All 10 cases were successfully completed intracorporeally without open conversion. Median total operative time was 6 hours, including 3.5 hours for pouch creation. Median blood loss was 200 cc and median hospital stay was 10 days. Four Clavien grade 1-2 and 3 Clavien 3-5 complications occurred. None of the patients had a bowel leak. One noncompliant patient requested undiversion to an ileal conduit. The remaining 9 patients successfully catheterized the ileal channel and were completely continent at the last followup at a median of 13.7 months (range 12.3 to 15.2). Study limitations include small sample size and short followup. Conclusions: We present what is to our knowledge the initial series of robotic completely intracorporeal Indiana pouch diversion. Early perioperative data indicate acceptable operative efficiency and complication rates. Longer followup is required to assess the functional outcomes of this less commonly performed diversion. References 1 : Oncologic, functional, and complications outcomes of robot-assisted radical cystectomy with totally intracorporeal neobladder diversion. Eur Urol2013; 64: 734. Google Scholar 2 : Robotic intracorporeal orthotopic neobladder during radical cystectomy in 132 patients. J Urol2014; 192: 1734. Link, Google Scholar 3 : Robotic intracorporeal continent cutaneous urinary diversion: primary description. J Endourol2015; 29: 1217. Google Scholar 4 : Enhanced recovery protocol after radical cystectomy for bladder cancer. J Urol2014; 192: 50. Link, Google Scholar 5 : Robotic intracorporeal orthotopic ileal neobladder: replicating open surgical principles. Eur Urol2012; 62: 891. Google Scholar 6 : Functional outcomes and complications in patients with bladder cancer undergoing robotic-assisted radical cystectomy with extracorporeal Indiana pouch continent cutaneous urinary diversion. Urology2012; 79: 1073. Google Scholar 7 : Ureteroenteric anastomosis in continent urinary diversion: long-term results and complications of direct versus nonrefluxing techniques. J Urol2000; 163: 450. Link, Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCacciamani G, Medina L, Lin-Brande M, Tafuri A, Lee R, Ghodoussipour S, Ashrafi A, Winter M, Ahmadi N, Rajarubendra N, Miranda G, De Castro Abreu A, Berger A, Aron M, Gill I and Desai M (2020) Timing, Patterns and Predictors of 90-Day Readmission Rate after Robotic Radical CystectomyJournal of Urology, VOL. 205, NO. 2, (491-499), Online publication date: 1-Feb-2021.Smith J (2017) This Month in Adult UrologyJournal of Urology, VOL. 198, NO. 2, (221-222), Online publication date: 1-Aug-2017. Volume 198Issue 2August 2017Page: 436-444Supplementary Materials Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsurinary diversioncontinentpostoperative complicationsurinary reservoirsroboticstreatment outcomeMetricsAuthor Information Mihir M. Desai More articles by this author Giuseppe Simone More articles by this author Andre Luis de Castro Abreu More articles by this author Sameer Chopra More articles by this author Mariaconsiglia Ferriero More articles by this author Salvatore Guaglianone More articles by this author Francesco Minisola More articles by this author Daniel Park More articles by this author Rene Sotelo More articles by this author Michele Gallucci More articles by this author Inderbir S. Gill More articles by this author Monish Aron More articles by this author Expand All Advertisement PDF downloadLoading ...