Department of Urology, Ohio State University Wexner Medical Center.
Department of Urology, Ohio State University Wexner Medical Center;
J Vis Exp. 2021 Mar 10(169). doi: 10.3791/61331.
The robotic approach to radical cystectomy is compelling because of its oncologic equivalence to open radical cystectomy (ORC), its association with lower surgical blood loss, its potential association with shorter hospital stay after surgery. These factors suggest that the robotic approach to radical cystectomy may be an important component of enhanced recovery programs aimed at reducing surgical morbidity. This paper describes the importance of the cranial placement of robotic trocars, the use of Cadiere forceps for atraumatic bowel grasping, pelvic lymph node dissection (PLND), and utero-enteric anastomoses. Also discussed are steps that are critical for the successful outcome of RARC. In spite of the increased operating times and associated costs and the costs of robotic surgical platforms and equipment, adoption of the robotic technique by bladder cancer surgeons has increased. This paper describes a systematic and reproducible method that details robotic extended pelvic lymph node dissection, cystectomy/cystoprostatectomy, and intracorporeal ileal conduit urinary diversion.
机器人辅助根治性膀胱切除术具有明显优势，因为它与开放性根治性膀胱切除术（ORC）相比具有相同的肿瘤学效果，且手术失血量更少，术后住院时间更短。这些因素表明，机器人辅助根治性膀胱切除术可能是旨在降低手术发病率的加速康复方案的重要组成部分。本文介绍了机器人套管在颅侧的重要性，以及使用 Cadiere 夹具进行无创伤性肠管抓取、盆腔淋巴结清扫（PLND）和子宫-肠吻合术。还讨论了 RARC 成功的关键步骤。尽管手术时间延长，相关成本以及机器人手术平台和设备的成本增加，但膀胱癌外科医生对机器人技术的采用有所增加。本文描述了一种系统且可重复的方法，详细介绍了机器人辅助广泛盆腔淋巴结清扫、膀胱切除术/膀胱前列腺切除术和腔内回肠导管尿流改道。
