Robotic-assisted radical cystoprostatectomy and intracorporeal ileal conduit formation in a patient with prior total colectomy and J-pouch

We present the first reported case of robotic-assisted radical cystoprostatectomy and ileal conduit formation in a patient with prior total colectomy and J-pouch. The anatomy posed significant technical risk due to end artery pouch perfusion and changes in the posterior plane. Intraoperative strategies, including rectal indocyanine green and a short discard segment when constructing the conduit enabled successful outcomes. The procedure was completed without complication, and the patient had a favourable oncologic and functional status postoperatively. This case demonstrates the technical considerations of cystectomy in patients with previous large bowel resection and reconstruction, and the outlined strategies are relevant across multiple clinical settings.