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Robot-assisted cystoprostatectomy with intracorporeal urinary diversion using a Hautmann technique

Epublication WebSurg.com, Mar 2012;12(03). URL: http://websurg.com/doi/vd01en3643

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It is the case of a 62-year-old man diagnosed with a T2bN0M0 transitional cell adenocarcinoma, which was evidenced by pathological findings after resection of a bladder tumor. Seven ports are required prior to the installation of the DaVinci® robotic system: - 12mm port on superior border of umbilicus. - Right robotic port at the midline between anterior superior iliac spine and umbilicus. - Two 5mm ports on both sides of right robotic port. - Additional 12mm port between the two 5mm ports once dissection of bladder pedicles has been started. - Two left robotic ports in left iliac fossa and anterior axillary line. This video demonstrates the cystoprostatectomy technique with a W-pouch intracorporeal neobladder (Hautmann ileal neobladder), which is feasible in specialized centers. References: 1. Kaufman DS, Shipley WU, Feldman AS. Bladder cancer. Lancet 2009;374(9685):239-49. 2. Lee DJ, Rothberg MB, McKiernan JM, Benson MC, Badani KK. Robot-assisted radical cystoprostatectomy in complex surgical patients: single institution report. Can J Urol 2009;16(3):4664-9. 3. Tunuguntla HS, Nieder AM, Manoharan M. Neobladder reconstruction following radical cystoprostatectomy for invasive bladder cancer. Minerva Urol Nefrol 2009;61(1):41-54. 4. Barocas DA, Patel SG, Chang SS, Clark PE, Smith JA Jr, Cookson MS. Outcomes of patients undergoing radical cystroprostatectomy for bladder cancer with prostatic involvement on final pathology. BJU Int 2009;104(8):1091-7. 5. Pruthi RS, Stefaniak H, Hubbard JS, Wallen EM. Robotic anterior pelvic exenteration for bladder cancer in the female: outcomes and comparisons to their male counterparts. J Laparoendosc Adv Surg Tech A 2009;19(1):23-7. 6. Kefer JC, Campbell SC. Current status of prostate-sparing cystectomy. Urol Oncol 2008;26(5):486-93. 7. Rawal S, Raghunath SK, Khanna S, Jain D, Kaul R, Kumar P, Chhabra R, Brushan K. Minilaparotomy radical cystoprostatectomy (Minilap RCP) in the surgical management of urinary bladder carcinoma: early experience. Jpn J Clin Oncol 2008;38(9):611-6. 8. Park SY, Cho KS, Ham WS, Choi HM, Hong SJ, Rha KH. Robot-assisted laparoscopic radical cystoprostatectomy with ileal conduit urinary diversion: initial experience in Korea. J Laparoendosc Adv Surg Tech A 2008;18(3):401-4. 9. Gregori A, Galli S, Goumas I, Scieri F, Stener S, Gaboardi F. A cost comparison of laparoscopic versus open radical cystoprostatectomy and orthotopic ileal neobladder at a single institution. Arch Ital Urol Androl 2007;79(3):127-9. 10. Young JL, Finley DS, Ornstein DD. Robotic-assisted laparoscopic cystoprostatectomy for prostatic carcinosarcoma. JSLS 2007;11(1)109- 12. 11. Nuñez-Mora C, Cabrera P, Garcia-Mediero JM, de Fata FR, Gonzalez J, Angulo J. Laparoscopic radical cystectomy and orthotopic urinary diversion in the malepatient: technique. Arch Esp Urol 2011;64(3):195-206. 12. Rehman J, Sangalli MN, Guru K, de Naeyer G, Schatteman P, Carpentier P, Mottrie A. Total intracorporeal robot-assisted laparoscopic ileal conduit (Bricker) urinary diversion: technique and outcomes. Can J Urol 2011;18(1):5548-56. 13. Canda AE, Asil E, Balbay MD. An unexpected resident in the ileum detected during robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal Studer pouch formation: Taenia saginata parasite. J Endourol 2011;25(2):301-3. 14. Lin T, Huang J, Han J, Xu K, Huang H, Jiang C, Liu H, Zhang C, Yao Y, Xie W, Shah AK, Huang L. Hybrid laparoscopic endoscopic single-site surgery for radical cystoprostatectomy and orthotopic ileal neobladder: an initial experience of 12 cases. J Endourol 2011;25(1):57-63. 15. Josephson DY, Chen JA, Chan KG, Lau CS, Nelson RA, Wilson TG. Robotic-assisted laparoscopic radical cystoprostatectomy and extracorporeal continent urinary diversion: highlight of surgical techniques and outcomes. Int J Med Robot 2010;6(3):315-23. 16. Kasraeian A, Barret E, Cathelineau X, Rozet F, Galiano M, Sánchez-Salas R, Vallancien G. Robot-assisted laparoscopic cystoprostatectomy with extended pelvic lymphadenectomy, extracorporeal enterocystoplasty, and intracorporeal enterourethral anastomosis: initial Montsouris Experience. J Endourol 2010;24(3):409-13. 17. Varinot J, Camparo P, Roupret M, Bitker MO, Capron F, Cussenot O, Witjes JA, Compérat E. Full analysis of the prostatic urethra at the time of radical cystoprostatectomy for bladder cancer: impact on final disease stage. Virchows Arch 2009;455(5):449-53. 18. Palou Redorta J, Gaya Sopena JM, Gausa Gascon K, Sanchez-Martin F, Rosales Bordes A, Rodriguez Faba O, Villavicencio Mavrich H. Robotic radical cystoprostatectomy: oncological and functional analysis. Actas Urol Esp 2009;33(7):759-66.