Tips and tricks to robot-assisted radical cystectomy and intracorporeal diversion.

Poch, Michael A; Raza, Johar; Nyquist, John; Guru, Khurshid A

PURPOSE OF REVIEW To summarize the fundamental principles for technique of robot-assisted radical cystectomy (RARC) based on current peer reviewed literature. Also provide most recent evidence for the efficacy of RARC and Intracorporeal Ileal Conduit (ICIC). RECENT FINDINGS Technical tricks have increased the efficiency of RARC and ICIC diversion. Perioperative and short-term outcomes have demonstrated that RARC is an acceptable alternative to open radical cystectomy. Acceptable positive surgical margin rates, thorough extended lymph node dissection based on tenets of oncological principles and acceptable short-term oncologic outcomes have been reported. Learning curve towards safe incorporation of intracorporeal urinary diversion and its evolution are presented. SUMMARY The technical tips and tricks have led to evolution of technique translating into improved surgical outcomes. RARC is a well tolerated and effective alternative to open cystectomy and urinary diversion. Intracorporeal urinary diversion is the next challenge on the horizon with an acceptable learning curve and outcomes; this evolution will lead to improvement in quality of life after this morbid surgical procedure.