Robot-assisted cystectomy with orthotopic vesicoplasty for bladder cancer

Introduction. Bladder cancer is the 10th most common cancer worldwide. Radical cystectomy remains the gold standard for muscle invasive bladder cancer. The active use of robot-assisted cystectomy for treating patients with bladder cancer allows considering it as an alternative surgical option. The review is aimed at collecting and systematizing the evidence base for intracorporeal robot-assisted cystectomy. Materials and methods. MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar, and Web of Science databases were used with the PICO (Patient-Intervention-Comparison-Outcome) search strategy to identify research articles published between 2000 and 2022. The following keywords were used to search the medical literature: «robot-assisted cystectomy», «RARC», «orthotopic neobladder», «intracorporeal RARC», «extracorporeal RARC», «bladder cancer», «functional outcomes», and «clinical outcomes». The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Exclusion criteria: abstracts, review articles, editor's notes and comments, book chapters; experimental and laboratory studies on animals or cadavers. Results and disscussion. A total of475 original articles were retrieved from the databases. Of them, 71 original articles were included in the analysis. The benefits and advantages of intracorporeal RARC at the intraoperative and postoperative period in comparison with RCE and extracorporeal RARC were reported. Functional and oncological outcomes following intracorporeal RARC are also comparable with RCE and extracorporeal RARC, suggesting the effectiveness and safety of the new surgical technology for treating patients with bladder cancer. Conclusions. The last decade has been marked with an active transition from traditional surgical techniques to robot-assisted surgery, enabling the precise performance, minimal trauma, and minimal intraoperative blood loss.