ROBOTIC RADICAL CYSTECTOMY OF THE BLADDER

Course overview

ROBOTIC RADICAL CYSTECTOMY IS A SURGICAL TECHNIQUE FOR MANAGING MUSCLE-INVASIVE BLADDER CANCER AND HIGH-RISK NON-MUSCLE–INVASIVE BLADDER CANCER. HISTORICALLY, OPEN RADICAL CYSTECTOMY WITH BILATERAL PELVIC LYMPH NODE DISSECTION AND URINARY DIVERSION WAS THE GOLD STANDARD. HOWEVER, THE RISE OF MINIMALLY INVASIVE SURGERY IN UROLOGY HAS LED TO THE WIDESPREAD ADOPTION OF ROBOTIC CYSTECTOMY, INCLUDING INTRACORPOREAL URINARY DIVERSION SURGERY. TYPICALLY, THIS SURGERY FOR UROTHELIAL CANCER IS PRECEDED BY NEOADJUVANT CISPLATIN-BASED CHEMOTHERAPY AND IS NOW COMMON IN TERTIARY CARE CENTERS FOR INVASIVE BLADDER CANCER.DESPITE ITS TECHNICAL CHALLENGES, LONG LEARNING CURVE, LONGER OPERATIVE TIMES, HIGHER COSTS, HIGH COMPLICATION RATE, AND SIGNIFICANT MORBIDITY SIMILAR TO THE OPEN APPROACH, ROBOTIC RADICAL CYSTECTOMY HAS GAINED POPULARITY. THIS PROCEDURE HAS DEMONSTRATED VARIOUS PERIOPERATIVE BENEFITS, INCLUDING LESS INTRAOPERATIVE BLOOD LOSS, REDUCED TRANSFUSION RATES, BETTER RATES OF POSITIVE MARGINS, MORE LYMPH NODES RECOVERED, AND SHORTER HOSPITAL STAYS WHILE MAINTAINING SIMILAR ONCOLOGIC OUTCOMES COMPARED TO OPEN SURGERY. THEREFORE, PERIOPERATIVE PROTOCOLS ARE ESSENTIAL TO REDUCE THE RISK OF POSTOPERATIVE COMPLICATIONS AND PROMOTE ENHANCED RECOVERY. THIS ACTIVITY FOCUSES ON SURGICAL INDICATIONS, OPERATIVE TECHNIQUES, COMPLICATIONS, AND MULTIDISCIPLINARY CARE INVOLVED WITH ROBOTIC RADICAL CYSTECTOMY, PRIMARILY FOCUSING ON ROBOTIC RADICAL CYSTECTOMY RATHER THAN PARTIAL CYSTECTOMY. THIS ACTIVITY ALSO PROVIDES CLINICIANS WITH A COMPREHENSIVE UNDERSTANDING OF THE LATEST TECHNIQUES AND TECHNOLOGIES, INCLUDING PATIENT SELECTION, PREOPERATIVE PLANNING, INTRAOPERATIVE STRATEGIES, AND POSTOPERATIVE CARE. IN ADDITION, THIS ACTIVITY EMPHASIZES THE ROLE OF MULTIDISCIPLINARY HEALTHCARE PROFESSIONALS IN THE CARE OF PATIENTS UNDERGOING ROBOTIC RADICAL CYSTECTOMY WITH BILATERAL PELVIC LYMPH NODE DISSECTION AND URINARY DIVERSION SURGERY.