937 ROBOT-ASSISTED INTRA-CORPOREAL ILEAL CONDUIT: MARIONETTE TECHNIQUE AND INITIAL EXPERIENCE AT ROSWELL PARK CANCER INSTITUTE

摘要

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion II1 Apr 2010937 ROBOT-ASSISTED INTRA-CORPOREAL ILEAL CONDUIT: MARIONETTE TECHNIQUE AND INITIAL EXPERIENCE AT ROSWELL PARK CANCER INSTITUTE Stéfanie Seixas-Mikelus, Abid Hussain, Aaron Blumenfeld, John Nyquist, Rameela Chandrasekhar, Gregory Wilding, and Khurshid Guru Stéfanie Seixas-MikelusStéfanie Seixas-Mikelus More articles by this author , Abid HussainAbid Hussain More articles by this author , Aaron BlumenfeldAaron Blumenfeld More articles by this author , John NyquistJohn Nyquist More articles by this author , Rameela ChandrasekharRameela Chandrasekhar More articles by this author , Gregory WildingGregory Wilding More articles by this author , and Khurshid GuruKhurshid Guru More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1816AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To present our technique and initial experience with patients who underwent robot-assisted intra-corporeal creation of ileal conduit and compare them with patients who underwent extra-corporeal ileal diversion after robot-assisted radical cystectomy. METHODS 26 patients diagnosed with invasive transitional cell carcinoma of the bladder underwent a robot-assisted radical cystectomy with bilateral extended pelvic lymphadenectomy with ileal conduit diversion. Total intra-corporeal ileal conduit creation was performed in the last thirteen patients. Operative data and short-term outcome between the two groups were assessed. The novel surgical technique for intra-corporeal ileal conduit will be presented. RESULTS The intra-corporeal group (IC) included 2 females and 11 males (mean age 71 years). The extra-corporeal group (EC) included 4 females and 9 males (mean age 66 years). No significant differences were noted between the groups in terms of patient age, BMI, sex, prior surgery or pathologic stage. Overall operative time and intra-operative complications were similar. No significant differences were noted between the two groups in terms of diversion time or estimated blood loss. There were four complications recorded in IC including: non-specific colitis, small bowel obstruction requiring exploratory laparotomy with lysis of adhesions, a urine leak that eventually resolved, but required a temporary nephrostomy tube, and a fourth patient with fever of unknown origin that resolved without intervention. CONCLUSIONS Robot-assisted intra-corporeal ileal conduit can be accomplished safely with acceptable operative times even during early experience. Larger series with favorable results will be required to add this new paradigm to minimally invasive surgery for bladder cancer. Buffalo, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e365 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stéfanie Seixas-Mikelus More articles by this author Abid Hussain More articles by this author Aaron Blumenfeld More articles by this author John Nyquist More articles by this author Rameela Chandrasekhar More articles by this author Gregory Wilding More articles by this author Khurshid Guru More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...