Strategies and Techniques for Ileourethral Approximation During Robotic Intracorporeal Neobladder Reconstruction

Background and objective: The use of robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion has increased rapidly in the past decade. The approximation of the ileum toward the urethral stump could be a demanding step. Whereas the techniques for reconstruction have been desc...

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Detalhes bibliográficos
Autores: Sighinolfi, M.C., Assumma, S., Wiklund, P., Gaston, R., Minervini, A., Mottrie, A., Mehrazin, R., Canda, A.E., Panio, E., Gavi, F., Sarchi, L., Calcagnile, T., Turri, F., Maida, F.D., Lambertini, L., Jhon, H., Coelho, R., Hosseini, A., Maes, K., Kumar, A., Rawal, S.K., Yuvaraja, T.B., Cacciamani, Giovanni E.|||0000-0002-8892-5539, Celia, A., Leonardo, C., Greco, F., Falabella, R., Annino, F., Galfano, A., Porreca, A., Crestani, A., Umari, P., Bertolo, R., Antonelli, Alessandro|||0000-0002-7455-8803, Papalia, R., Falagario, U., Schiavina, R., Sfakianos, J., Tillu, N., Wijburg, C., Tondolo, V., Alfieri, S., Breda, Alberto|||0000-0002-7842-9048, Gaia, G., Terzoni, S., Moschovas, M.C., Patel, V., Rocco, B.
Tipo de documento: artigo
Data de publicação:2025
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:322754
Acesso em linha:https://ddd.uab.cat/record/322754
https://dx.doi.org/urn:doi:10.1016/j.euros.2025.03.018
Access Level:Acceso aberto
Palavra-chave:Anastomosis
Bladder cancer
Bowel
Intracorporeal neobladder
Robotic cystectomy
Surgical technique
Descrição
Resumo:Background and objective: The use of robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion has increased rapidly in the past decade. The approximation of the ileum toward the urethral stump could be a demanding step. Whereas the techniques for reconstruction have been described in detail, a comprehensive depiction of strategies to facilitate neobladder-urethral approximation is lacking. This manuscript and video collection provide a summary of the techniques and maneuvers suggested by RARC surgeons. Methods and surgical procedure: This is a cross-sectional study in collaboration with the European Association of Urology Robotic Urology Section (ERUS) Scientific Working Group that evaluates strategies for ileourethral approximation and anastomosis from surgeons performing RARC with an intracorporeal neobladder. To this purpose, a survey was developed by a single institution with input from experts. The survey included questions on caseload, types of diversions, ileal approximation, and techniques and strategies for overcoming challenges in an ileourethral anastomosis. Responders were recruited among experts from scientific societies and were asked to rate the importance of these tricks on a Likert scale. A video collection was developed thereafter. Key findings and limitations: Twenty-one surgeons were involved, with five of them having an individual caseload of.

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