Robotic-assisted laparoscopic radical cystectomy: surgical and oncological outcomes

purpose:our first 91 consecutive cases undergoing a robotic assisted cystectomy were analyzed regarding perioperative outcomes, pathological stages and surgical complications. materials and methods: between 2007 and 2010 a total of 91 patients (76 male and 15 female), 86 with clinically localized bladder cancer and 5 with non-urothelial tumors underwent a radical robotic assisted cystectomy. we analyzed the perioperative factors, length of hospital stay, pathological outcomes and complication rates. results: mean age was 65.6 years (range 28 to 82). among the 91 patients, 68 were submitted to an ileal conduit and 23 to a neobladder procedure for urinary diversion. mean operating time was 412 min (range: 243-618 min.) and mean blood loss was 294 ml (range: 50-2000 ml). in 29% of the cases with urothelial carcinoma the t-stage was pt1 or less, 38% were pt2; 26% and 7% were classified as pt3 and pt4, respectively. 14% of cases had lymph node positive disease. mean number of lymph nodes removed was 15 (range 4 to 33). positive surgical margins occurred in 2 cases (2.1%). mean days to flatus were 2.13, bowel movement 2.88 and inpatient stay 18.8 (range: 10-33). there were 45 postoperative complications with 11% major (clavien grade 3 or higher). at a mean follow-up of 15 months 10 patients had disease recurrence and 6 died of the disease. conclusions: our experience demonstrates that robotic assisted radical cystectomies for the treatment of bladder cancers seems to be very promising regarding surgical and oncological outcomes.