REVIEW   Free access

Minerva Urologica e Nefrologica 2017 February;69(1):14-25

DOI: 10.23736/S0393-2249.16.02780-6

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Robotic intracorporeal urinary diversion: practical review of current surgical techniques

Fabrizio DAL MORO ¹, Georges P. HABER ², Peter WIKLUND ³, Abdullah E. CANDA ⁴, Mevlana D. BALBAY ⁵, Arnulf STENZL ⁶, Filiberto ZATTONI ¹, Joan PALOU ⁷, Inderbir GILL ⁸, James W. CATTO ⁹ ✉

¹ University of Padua, Padua, Italy; ² Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, USA; ³ Karolinska University Hospital, Stockholm, Sweden; ⁴ Department of Urology, Yildirim Beyazit University, School of Medicine, Ankara Ataturk Training and Research Hospital, Ankara, Turkey; ⁵ Department of Urology, Memorial Şişli Hospital, Istanbul, Turkey; ⁶ Department of Urology, Eberhard-Karls University Tuebingen, Germany; ⁷ Fundació Puigvert, Barcelona, Spain; ⁸ Institute of Urology, Keck School of Medicine, USC, Los Angeles, CA, USA; ⁹ University of Sheffield, Sheffield, UK

In this practical review, we discuss current surgical techniques reported in the literature to perform intracorporeal urinary diversion (ICUD) after robotic radical cystectomy (RARC), emphasizing criticisms of single approaches and making comparisons with extracorporeal urinary diversion (ECUD). Although almost 97% of all RARCs use an ECUD, ICUD is gaining in popularity, in view of its potential benefits (i.e., decreased bowel exposure, etc.), although there are a few studies comparing ICUD and ECUD. Analyzing single experiences and the data from recent metanalyses, we emphasize the current critiques to ICUD, stressing particular technical details which could reduce operative time, lowering the postoperative complications rate, and improving functional outcomes. Only analysis of long-term follow-up data from large-scale homogeneous series can ascertain whether robotic intracorporeal urinary diversion is superior to other approaches.

KEY WORDS: Cystectomy - Urinary diversion - Urinary bladder