Robotic-Assisted Laparoscopic Pelvic Lymphadenectomy for Bladder Cancer: A Surgical Atlas

Abstract

INTRODUCTION: Recently, robotic approaches to cystectomy have been reported. Lymphadenectomy remains an important diagnostic component of cystectomy. As with resection of the primary tumor, the use of new technologies must not compromise the oncological benefits of lymphadenectomy, We describe our approach to and results of robotic-assisted laparoscopic pelvic lymphadenectomy in cystectomy. TECHNIQUE: We describe the technique of standard and extended pelvic lymph node dissection during robotic-assisted cystectomy. The classic da Vinci or the da Vinci S robotic platform is utilized for lymphadenectomy. RESULTS: Twenty-eight patients underwent a standard dissection with a mean number of lymph nodes removed of 19 (range, 8-33). Extended lymph node dissection has been performed in 22 patients with a mean of 30 lymph nodes removed (range, 12-39). No surgical complications have occurred related to the lymphadenectomy. CONCLUSIONS: Robotic laparoscopic pelvic lymphadenectomy is feasible and safe, and is equivalent in efficacy to open approaches in bladder cancer.