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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
          J. Endourol
          end
          Journal of Endourology
          Mary Ann Liebert, Inc. (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
          0892-7790
          1557-900X
          01 November 2015
          : 29
          : 11
          : 1217-1220
          Affiliations
          [ 1 ] Methodist Institute for Technology , Innovation, and Education, Houston Methodist Hospital, Houston, Texas.
          [ 2 ]Department of Urology, Houston Methodist Hospital , Houston, Texas.
          [ 3 ]Scott Department of Urology, Baylor College of Medicine , Houston, Texas.
          Author notes

          A video demonstrating this technique is available at www.liebertpub.com/end

          Address correspondence to: Alvin C. Goh, MD, Department of Urology, Methodist Institute for Technology, Innovation, and Education Houston Methodist Hospital, 6560 Fannin Street, Suite 2100, Houston, TX 77030, E-mail: acg622@ 123456gmail.com
          Article
          PMC4702439 PMC4702439 4702439 10.1089/end.2014.0750
          10.1089/end.2014.0750
          4702439
          25556514
          5b485d42-0356-49e1-8820-e7d3bd4dcc80
          Copyright 2015, Mary Ann Liebert, Inc.
          History
          Page count
          Figures: 6, References: 12, Pages: 4
          Categories
          Techniques in Endourology

          J. Stuart Wolf, Jr., MD

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