Robotic urinary diversion: the range of options

Curr Opin Urol. 2016 Jan;26(1):107-13. doi: 10.1097/MOU.0000000000000248.

Abstract

Purpose of review: To review current status and controversies on robotic intracorporeal urinary diversion (RICUD). We discuss the current status of urinary diversion, including complications and current types of RICUD, the available options for RICUD going forward for robotic radical cystectomy (RRC) patients, and the current critiques of RICUD.

Recent findings: Although the majority of centers conclude RRC with an extracorporeal urinary diversion (ECUD), the number of total RICUD being performed worldwide is increasing. Although limited, ICUD may provide comparable, if not superior, outcomes to ECUD, though at the moment this technique has been performed mostly by highly experienced and skilled robotic surgeons who have performed a high volume of ICUDs. Several ICUD options are available, and improvements and increased experience with this technique can lead to comparable outcomes; however, this is yet to be validated.

Summary: At the current moment ECUD is still the norm following RRC. However, ICUD is gaining steam and becoming more commonly used. Several urinary diversion options can be accomplished intracorporeally including continent and noncontinent orthotopic and nonorthotopic urinary diversions. Further experience with these techniques by additional centers is required.

Publication types

  • Review

MeSH terms

  • Cystectomy*
  • Humans
  • Postoperative Complications / etiology
  • Risk Factors
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Diversion / adverse effects
  • Urinary Diversion / methods*