Literature DB >> 28467725

Feasibility, Morbidity, and Functional Results of Supratrigonal Cystectomy with Augmentation Ileocystoplasty by Combined Robot-Assisted Laparoscopy and Mini-Laparotomy Approach.

François Xavier Madec1, Oussama Hedhli1, Marie-Aimée Perrouin-Verbe1, Amélie Levesque1, Loïc Le Normand1, Jérôme Rigaud1.   

Abstract

OBJECTIVES: Evaluation of the feasibility, morbidity, learning curve, and functional results of robotic supratrigonal cystectomy with augmentation ileocystoplasty (RSCAI).
MATERIALS AND METHODS: RSCAI was performed in 19 patients between 2012 and 2016. Thirteen patients (66.4%) presented refractory detrusor overactivity or impaired compliance and 6 patients (31.6%) had painful bladder syndrome. A combined robot-assisted laparoscopy and mini-laparotomy approach was performed. Early (<30 days) and late (>30 days) complications were reported according to the Clavien-Dindo classification. Functional results were analyzed according to the surgical indication.
RESULTS: Mean total operating time was 288.7 ± 92.1 minutes. Mean intraoperative blood loss was 147.4 ± 144.8 mL. Mean length of hospital stay in the surgical ward was 9.4 ± 3.7 days. Mean duration of bladder drainage was 23.3 ± 4.1 days. For surgeons who regularly performed robot-assisted laparoscopy, the learning curve of this technique, as assessed by the operating time, required almost five operations. No major (Clavien-Dindo >2) early (0%) or late (0%) postoperative complication was observed. Early minor complications were observed in 47.4% of cases, usually consisting of pyelonephritis (21.1%). Late minor complications (10.5%) were Clavien-Dindo grade I. Mean follow-up was 13.6 ± 10.1 months. The majority of patients (94.7%) obtained functional improvement of their disease in terms of pain, functional bladder capacity, or bladder compliance.
CONCLUSION: Our RSCAI technique is a reliable technique with no early or late major postoperative complications reported in this series. This technique allows patients to be operated by minimally invasive surgery with very satisfactory long-term functional results.

Entities:  

Keywords:  bladder; bladder pain syndrome; ileocystoplasty; robotics; supratrigonal

Mesh:

Year:  2017        PMID: 28467725     DOI: 10.1089/end.2017.0107

Source DB:  PubMed          Journal:  J Endourol        ISSN: 0892-7790            Impact factor:   2.942


  2 in total

Review 1.  The current state and the future of robotic surgery in female pelvic medicine and reconstructive surgery.

Authors:  Rachael D Sussman; Benoit Peyronnet; Benjamin M Brucker
Journal:  Turk J Urol       Date:  2019-09-01

Review 2.  Expanding the indications of robotic surgery in urology: A systematic review of the literature.

Authors:  Raj P Pal; Anthony J Koupparis
Journal:  Arab J Urol       Date:  2018-08-07
  2 in total

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