Andre Berger1, Monish Aron. 1. Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Abstract
PURPOSE OF REVIEW: Laparoscopic radical cystectomy is being increasingly performed at several centers across the world. This review analyzes the published perioperative and oncologic outcomes of this procedure. RECENT FINDINGS: Minimally invasive radical cystectomy for bladder cancer is performed laparoscopically or robotically. Urinary diversion is currently usually performed extracorporeally through a small open incision in order to decrease operating time and minimize bowel complications. Although rigorous comparisons with open cystectomy are lacking, minimally invasive radical cystectomy appears to have superior perioperative outcomes. Although long-term outcomes after minimally invasive radical cystectomy are limited, intermediate term oncologic outcomes appear comparable to open radical cystectomy, the reference standard. SUMMARY: Minimally invasive radical cystectomy is technically feasible. Perioperative outcomes are as good as open radical cystectomy if not better. Intermediate term oncologic outcomes compare well with open radical cystectomy. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between minimally invasive radical cystectomy and open radical cystectomy is needed to define the role of these modalities in the current context.
PURPOSE OF REVIEW: Laparoscopic radical cystectomy is being increasingly performed at several centers across the world. This review analyzes the published perioperative and oncologic outcomes of this procedure. RECENT FINDINGS: Minimally invasive radical cystectomy for bladder cancer is performed laparoscopically or robotically. Urinary diversion is currently usually performed extracorporeally through a small open incision in order to decrease operating time and minimize bowel complications. Although rigorous comparisons with open cystectomy are lacking, minimally invasive radical cystectomy appears to have superior perioperative outcomes. Although long-term outcomes after minimally invasive radical cystectomy are limited, intermediate term oncologic outcomes appear comparable to open radical cystectomy, the reference standard. SUMMARY: Minimally invasive radical cystectomy is technically feasible. Perioperative outcomes are as good as open radical cystectomy if not better. Intermediate term oncologic outcomes compare well with open radical cystectomy. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between minimally invasive radical cystectomy and open radical cystectomy is needed to define the role of these modalities in the current context.