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Robotic bladder diverticulectomy: Technique and surgical outcomes
Author(s) -
Altunrende Fatih,
Autorino Riccardo,
Patel Neil S,
White Michael A,
Khanna Rakesh,
Laydner Humberto,
Yang Bo,
Haber GeorgesPascal,
Kaouk Jihad H,
Stein Robert J
Publication year - 2011
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2010.02716.x
Subject(s) - medicine , surgery , foley catheter , perioperative , diverticulum (mollusc) , urinary system , dissection (medical) , ureter , lower urinary tract symptoms , cystoscopy , complication , catheter , prostate , cancer
Objectives: Indications for surgical treatment of bladder diverticula include tumor, lower urinary tract symptoms refractory to medical treatment, renal dysfunction or recurrent urinary tract infections. We describe the technique and report the outcomes of robotic bladder diverticulectomy at our institution. Methods: A chart review of patients who underwent robotic bladder diverticulectomy at our institution from 2007 to 2010 was carried out. Indications for the procedure were: lower urinary tract symptoms (LUTS) not responding to medical treatment (2 patients), ureteral obstruction (1 patient), tumor arising in a diverticulum (2 patients) and diverticulum secondary to neurogenic bladder (1 patient). One patient also had renal dysfunction associated with ureteral insertion into the diverticulum and therefore underwent ipsilateral ureteroneocystostomy. Other additional procedures included transurethral resection of the prostate (1 patient) and bilateral pelvic lymph node dissection (1 patient). Perioperative and postoperative outcomes were analyzed. Results: Six patients (median age 61.5 years, range 19–75) underwent da Vinci diverticulectomy using a transperitoneal approach without the need for open conversion. Median operative time was 232 min (135–360 min.). Median estimated blood loss was 100 mL (50–150 mL). The Foley catheter was removed after a negative cystogram and median time to catheter removal was 7 days (7–12 days). Median hospital stay was 3 days (2–5 days). The only complication was a urinary tract infection managed with antibiotics. Conclusions: Robotic surgery represents a reasonable minimally invasive treatment option for resection of bladder diverticula when indicated.