Robot assisted radical cystectomy : a new standard ?

Robot-assisted surgery has become the gold standard surgical approach for most urological procedures over the last 20 years. Radical cystectomy follows the same trend although the generalization of a full robotic approach takes much longer compared to the widespread use of robotic prostatectomy or renal tumorectomy.

Six prospective trials have compared the results of open vs. robot cystectomy since 2010. Although oncological equivalence has been demonstrated, none have proven the benefit of the robot-assisted approach in reducing the rate of postoperative complications. Robotic surgery allows a significantly lower blood loss, faster post-operative rehabilitation and a shorter hospitalization period at the cost of a longer operating time and an additional cost of more than 1000 euros per intervention. Finally, the learning curve remains long, compromising the wide use of intracorporeal reconstruction techniques.