Single port robot assisted radical cystectomy with Ileal conduit and orthotopic neobladder reconstruction: Video article and step-by-step technique

Urinary bladder cancer is a common oncological disease. Single Port Robot-Assisted Radical Cystectomy (SP RARC) represents an innovative approach that has been increasingly utilized for performing radical cystectomy. In this video article, we aim to present a step-by-step technique of SP RARC, describing both ileal conduit and orthotopic neobladder configurations, along with a summary of the perioperative outcomes from our initial cases. Nine consecutive patients who underwent SP RARC have been retrospectively reviewed. Of these, 7 received an ileal conduit urinary diversion, while 2 underwent orthotopic neobladder reconstruction. All procedures were conducted intracorporeally. For all cases, a15 mm assistant trocar was placed in the right abdominal quadrant. For ileal conduit, this was placed on the anticipated stoma site. Anamnestic and perioperative data were collected for each patient. All procedures were successfully completed. One case required conversion to open surgery due to hemodynamic instability associated with the Trendelenburg position. No complications were observed during the remaining surgeries or through the hospitalization period. Whitin 90 days postoperatively, 3 patients were readmitted: one for Clavien-Dindo I complication and 2 for Clavien-Dindo III complications. SP RARC with ileal conduit and orthotopic neobladder reconstruction is a feasible and safe approach. Further studies are required to investigate the feasibility of novel urinary diversion techniques.