Current role of robotic bladder cancer surgery

© 2019 EDIZIONI MINERVA MEDICA. INTRODUCTION: Radical cystectomy (RC ) is one of the most complex and morbid surgical procedures in urology, that is not devoid of postoperative complications. Minimally invasive surgery, and especially robot-assisted RC (RARC ) has emerged as an alternative to open RC (ORC ) in an attempt to minimize surgical morbidity and facilitate the surgical approach. The aim of this paper was to present the current knowledge on the oncological efficacy and complication outcomes of RARC . E VIDENCE AC QUISITIO N: A non-systematic review on all relevant studies with the keywords "Radical cystectomy," "Open," "Robot-assisted," "Complications," "Recurrence," "Survival," "Neobladder," "Potency," "Continence" and "Intracorporeal" was performed using PubMed, MEDLI NE, Embase, American Urological Association (AUA), European Society of Medical Oncology (ESMO) and European Association of Urology (EA U) Guidelines. E VIDENCE SYNTHESIS: RARC shows similar lymph node yields and positive surgical margin rates as well as perioperative complication outcomes compared with ORC. RARC exhibits significantly less blood loss and less intra- and postoperative blood transfusion. Moreover, survival and recurrence rates are not related to the surgical approach. Finally, RARC seems to be more expensive and has a longer operating time compared to the open technique. CO NCL USIO NS: As current evidence shows, RARC seems as a technically feasible and safe procedure, providing equivalent perioperative and oncological results compared to ORC . More prospective, randomized-controlled trials are necessary to draw definitive conclusions on all comparative aspects.