AB009. SOH24AB_109. Robotic intracorporeal ileal conduit urinary diversion following robotic radical cystectomy: our experience

Background: Radical cystectomy (RC) with pelvic lymph node dissection and urinary diversion is the gold-standard therapy for localized muscle-invasive bladder cancer (MIBC). Ileal conduit (IC) is the most common urinary diversion utilised by urologists. The use of robotic approach to RC and IC has increased in recent years. Our objective is to report our experience for robotic intracorporeal IC urinary diversion and highlight key aspects of our surgical technique.

Methods: Following robotic RC, robotic IC urinary diversion were performed in five patients for MIBC following discussion at our multi-disciplinary meeting. Combination of 60-mm robotic gastrointestinal anastomosis (GIA) stapler and laparoscopic GIA stapler were used to isolate the ileal loop and then to form side-to-side ileo-ileal anastomosis. Uretero-ileal anastomoses over double-J stent were performed using Bricker technique in four cases and Wallace technique in one case. We describe operative details of our technique in the video.

Results: Median age was 70 years. Median time of intracorporeal IC formation was 140 min. Median console time for robotic RC and IC was 360 min. Median blood loss was 250 mL. There were no intra-operative complications. Median length of hospital stay was 8 days. Double-J stents were removed after 6 weeks via conduitoscopy using flexible cystoscopy. There were no post-operative mortality.

Conclusions: Although operative time was longer, robotic intracorporeal IC urinary diversion is a technically feasible and safe procedure with the benefits of minimally invasive surgery.

Keywords: Robotic urinary diversion; robotic cystectomy; intra-corporeal urinary diversion; ileal conduit (IC); pelvic lymph node dissection