AB124. SOH23ABS_087. Robotic transabdominal combined transvesical and extravesical repair of multiple bladder diverticulae: our technique

Background: Bladder diverticulum is one of the causes voiding dysfunction. Conventional open repair of multiple bladder diverticula can have significant morbidity which can potentially be minimised with minimally invasive surgery (MIS) with the use of robotic platform. We report our techniques and experience in a case of multiple bladder diverticulae which was repaired using a dual console da Vinci Xi surgical system.

Methods: A 60-year-old man developed refractory voiding dysfunction secondary to multiple bladder diverticulae which was severely affecting his quality of life. Urodynamic studies, imaging studies and cystoscopy confirmed multiple large bladder diverticulae affecting left lateral wall and right lateral wall of the bladder. He was counselled for robotic repair of bladder diverticulae. We describe operative details and our technique in video.

Results: Xi robotic platform was utilised and a transperitoneal, combined extravesical and transvesical approach was used. Two diverticulae were identified in the left lateral bladder wall and one on the right lateral bladder wall were excised and a 2-layered repair was performed. A Robinsons drain and catheter left in-situ. The patient made an uneventful recovery. Cystogram at 2 weeks post-op demonstrated no leak and catheter was removed. At 3 months post-operative, patient reported resolution of voiding dysfunction.

Conclusions: Robotic transabdominal combined extravesical and transvesical repair of bladder diverticulae is a safe and effective technique with all the advantages of MIS.

Keywords: Bladder diverticulum; minimally-invasive-surgery (MIS); robotic surgery; voiding dysfunction; bladder diverticulectomy