Surgical robots for radical cystectomies in a medium-volume hospital.

Aim The use of surgical robots for radical cystectomies is increasing. In the present study, we evaluated the surgical outcomes after the transition from open radical cystectomy (ORC) to robot-assisted radical cystectomy (RARC) in a medium-volume hospital. Patients and Methods The present study was a retrospective review of radical cystectomies undertake at a university hospital. Ninety radical cystectomies were identified between 2006 and 2014, and divided into three cohorts of 30 cases. The surgical approach changed gradually from ORC to RARC. Patients' demographic data, length of hospital stay and surgical outcomes were reviewed and compared across the three periods. Results In cohorts 1, 2 and 3, radical cystectomies were robot assisted in 13.3, 33.3 and 83.3 per cent of cases, respectively. The overall length of stay (LOS) was similar in all cohorts. The median LOS after cystectomy with ileal conduit diversion reduced significantly from 19 to 12 days ( P < 0.0005). The rate of positive surgical margins was 20, 3.3 and 3.3 per cent in cohorts 1, 2 and 3, respectively, which was statistically significant ( P = 0.046). There was no difference in the rate of severe complications (Clavien grades 3-5) at 30 and 90 days. Conclusion RARC can be safely applied in medium-volume hospitals. Further investigation is needed to evaluate the advantages of RARC over ORC and laparoscopic approaches. [ABSTRACT FROM AUTHOR]