MORBIDITY ASSOCIATED WITH ROBOTIC CYSTOPROSTATECTOMY: INITIAL EXPERIENCE
John M. Corman, M.D., Alvaro Lucioni, M.D., Evan T. Auerbach, B.S., Thomas R. Pritchett, M.D., Erika M. Wolff, Ph.D.
Section of Urology and Renal Transplantation, Virginia Mason, Seattle, WA
Robotic-assisted laparoscopic radical cystectomy (RARC) has emerged as an accepted technique for the management of muscle invasive bladder cancer.
Selection of this surgical approach is based upon a perception of equivalent oncologic outcomes when compared to open surgical techniques as well as improved peri-operative measures.
Given the recent focus on robotic surgical learning curves, it is of particular interest to delineate whether the morbidity with cystoprostatecomy is improved with RARC.
We evaluated peri-operative morbidity in an initial series of 30 RARCs performed in a center that has an established robotic prostatectomy program.
An IRB-approved retrospective database was utilized to evaluate the first 30 consecutive patients that underwent RARC at Virginia Mason.
All reconstructions were performed ex-vivo (ileal conduit vs. continent cutaneous diversion vs ileal neobladder).
Peri-operative morbidity was defined and categorized according to the Clavien-Dindo Classification system.
RARC is associated with significant morbidity, even at a center with extensive experience in robotic oncologic surgery.
RARC is emerging as an accepted extirpative procedure in the management of muscle invasive bladder cancer.
While RARC may increase cost and OR time, length of hospital stay is lower compared to open surgical techniques.
Accurate reporting of complications is crucial for the critical assessment of RARC.