Objective
To report our experience in robot-assisted laparoscopic bladder diverticulectomy (RALBD)
with a focus on technical modifications aimed at accommodating for differences in
anatomy and pathologies.
Materials and Methods
A prospective database was maintained for 20 patients who had RALBD at our institution.
Clinicopathological and follow-up details including concomitant procedure performed
were reviewed for each case. Two patients had intra-diverticular urothelial carcinoma
refractory to endoscopic and intravesical management. The dissection of the diverticular
neck was performed utilising one of the 3 approaches: extravesical (8 of 20 patients),
transvesical (11), and trans-diverticular (1). Pre and postoperative postvoid residual
and International Prostate Symptom Score were compared using paired-sample t test. In addition, 6 patients underwent open bladder diverticulectomy during the
period and their perioperative parameters were compared with the RALBD group.
Results
The median age was 66 and the average BMI was 27.2. Thirteen patients underwent major
concomitant urologic procedures. Mean operative duration was 184 minutes with average
length of hospital stay at 2.1 days. One Clavien 3 complication was encountered. There
were significant improvements in pre & postoperative postvoid residual (425-49 ml,
P = .000) and International Prostate Symptom Score (19-6, P = .033). When compared to open bladder diverticulectomy, RALBD is associated with
reductions in blood loss (100 ml vs 283 ml, P = 0.003).
Conclusion
Despite the wide variability in clinical presentations, RALBD is associated with minimal
surgical morbidity and good perioperative outcomes. It can be safely performed in
conjunction with other major urologic procedures in the pelvis.
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Article info
Publication history
Published online: August 07, 2020
Accepted:
July 29,
2020
Received:
April 22,
2020
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2020 Published by Elsevier Inc.
