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      Robotic Intracorporeal Continent Cutaneous Urinary Diversion: Primary Description.

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          Abstract

          The purpose is to present the first report and describe our novel technique for intracorporeal continent cutaneous diversion after robotic cystectomy. After completion of robot-assisted cystectomy using a standard six-port transperitoneal technique, three additional ports are placed, and the robot is redocked laterally over the patient's right side in the modified lateral position. Our technique replicates step-by-step the principles of the open approach. Ileocolonic anastomosis, ureteroenteral anastomoses, and construction of a hand-sewn right colonic pouch are all performed intracorporeally. Tapering of efferent ileal limb and reinforcement of the ileocecal valve are performed via the extraction site, while the stoma is matured through a prospective port site. Successful robotic intracorporeal creation of a modified Indiana pouch was achieved. Operative time for diversion was 3 hours, with negligible blood loss, and without any intraoperative complications. No major (Clavien III-V) 90-day complications were observed. At a follow-up of 1 year, the patient continues to catheterize without difficulty. We demonstrate the first description of robotic intracorporeal continent cutaneous urinary diversion after robot-assisted cystectomy. We present a systematic minimally invasive approach, replicating the principles of open surgery, which is technically feasible and safe with a good functional result.

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          Author and article information

          Journal
          J. Endourol.
          Journal of endourology
          Mary Ann Liebert Inc
          1557-900X
          0892-7790
          Nov 2015
          : 29
          : 11
          Affiliations
          [1 ] 1 Methodist Institute for Technology , Innovation, and Education, Houston Methodist Hospital, Houston, Texas.
          [2 ] 2 Department of Urology, Houston Methodist Hospital , Houston, Texas.
          [3 ] 3 Scott Department of Urology, Baylor College of Medicine , Houston, Texas.
          Article
          10.1089/end.2014.0750
          4702439
          25556514

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