Peri- and postoperative outcomes of robot-assisted radical cystectomy (RARC)

Objective: • To assess peri-and postoperative outcomes of robot-assisted radical cystectomy (RARC) with pelvic lymph node dissection (PLND) and urinary diversion for the treatment of bladder cancer.

Materials and methods: • We review our previously described surgical technique for RARC and its development over recent years, with an accompanied video illustration. • We also focus on peri- and postoperative outcomes of RARC and compare this with the 'gold standard' of open RC.

Results: • RARC has been steadily growing since 2003, with acceptable peri-and postoperative outcomes. • Most studies report decreased blood loss, return of bowel function, and shorter length of hospital stay. Furthermore, complication rates have been shown to be similar to that of open series. • Most importantly, oncological outcomes appear to be favourable in terms of margin status, LND and disease-specific survival, although data may be affected by the lack of long-term results and a randomized clinical trial assessing overall survival.

Conclusions: • RARC with PLND and urinary diversion is an increasingly used strategy in the treatment armamentarium for bladder cancer. • Perioperative and oncological outcomes from existing data have been favourable thus far, but are limited by relatively short follow-up. • Randomized clinical trials with extended patient follow-up are needed to fully assess outcomes related to RARC.