Prevention and management of complications following robot-assisted radical cystectomy: lessons learned after >250 consecutive cases.
Angela B Smith, Michael E Woods, Mathew C Raynor, Matthew E Nielsen, Eric M Wallen, Raj S Pruthi
Author Information
Angela B Smith: Division of Urologic Surgery, The University of North Carolina at Chapel Hill, 2113 Physicians Office Bldg CB 7235, 170 Manning Drive, Chapel Hill, NC 27599-7235, USA. angela_smith@med.unc.edu
INTRODUCTION: Numerous case series of robot-assisted radical cystectomy have emerged which describe complication rates comparable to open series. However, various reports have outlined preoperative factors as predictors of postoperative complications. Understanding these factors and the methods to optimize the perioperative care of the robotic cystectomy patient is essential for successful outcomes. METHODS: In this topic paper, we briefly review the literature surrounding complication rates following robot-assisted radical cystectomy as well as describe our experience after >250 cases, outlining our suggestions for avoidance of surgical complications when building a practice that incorporates this technique. RESULTS: Due to numerous variables, there are a number of intra-operative considerations, including patient selection, perioperative care pathway, intra-operative technique, and equipment choice that we have found to decrease post-operative complications and improve patient outcomes. CONCLUSION: Through careful patient selection, use of appropriate equipment and perioperative surgical management, robotic cystectomy is a feasible procedure with excellent perioperative results.
