Robot-assisted ileocystoplasty for the treatment of adult neurogenic bladder: A video demonstration and outcomes

Abstract

Ileocystoplasty is one of the treatment options in the armamentarium for the management of adults with neurogenic bladder dysfunction, after failure of less invasive treatment alternatives, such as intravesical onabotulinum toxin A injection therapy and sacral neuromodulation. It has traditionally been performed as open surgery and can be associated with significant morbidity, especially in the early postoperative period.^[1] Complications associated with open ileocystoplasty include prolonged postoperative ileus, wound infections, and pain. Performing robot-assisted ileocystoplasty can reduce the morbidity associated with open surgery^[2] and has been shown to be safe and feasible in experienced hands,^[3] although it may be associated with increased operative duration because of its learning curve. Our technique of robot-assisted ileocystoplasty and early postoperative outcomes is demonstrated in this video (Supplemental Digital Content, https://links.lww.com/CURRUROL/A47).

Robotic console time was 180 minutes, with minimal blood loss. Eight-hourly catheter aspiration and flushes were performed to manage the mucus in the urine. There were no metabolic acidosis or electrolyte derangements postoperatively. The patient was discharged on postoperative day 5. Postoperative cystogram at week 2 showed no leak and the patient is doing well at 1 year postoperatively. Robotic ileocystoplasty is safe and feasible and can reduce the morbidity associated with open surgery with good outcomes.

Keywords

Bladder augmentation / Minimally invasive surgery / Robot-assisted ileocystoplasty

Acknowledgments

The publishing team would like to acknowledge the excellent care rendered by Dr Matthew Ho and the perioperative care team at North Shore Private Hospital, as well as Samuel Hilton at Sydney Urological Associates for his assistance, which made this publication possible.

Statement of ethics

The publication was carried out in accordance with the Declaration of Helsinki. Written informed consent was obtained from the patient featured in this video for photo and video recording, as well as for publication of the photos and video materials. Institutional Review Board's approval was not required as this was for one patient with written informed consent obtained.

Conflict of interest statement

No conflict of interest has been declared by the authors.

Funding source

None.

Author contributions

SY, AG, AC: Conception and design;

SY, AC: Data collection;

SY: Video editing and manuscript;

SY, AG, AC: Manuscript revision and final approval.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

[1] Çetinel B, Kocjancic E, Demirdağ Ç. Augmentation cystoplasty in neurogenic bladder. Investig Clin Urol 2016; 57(5):316-323.

[2] Murthy P, Cohn JA, Gundeti MS. Robotic approaches to augmentation cystoplasty: Ready for prime time? Curr Bladder Dysfunct Rep 2014;9:310-317.

[3] Grilo N, Chartier-Kastler E, Grande P, Crettenand F, Parra J, Phé V. Robot-assisted supratrigonal cystectomy and augmentation cystoplasty with totally intracorporeal reconstruction in neurourological patients: Technique description and preliminary results. Eur Urol 2021; 79(6):858-865.