UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

The Role of Robotics in the Invasive Management of Bladder Cancer

Khetrapal, P; Tan, WS; Lamb, B; Tan, M; Baker, H; Thompson, J; Sridhar, A; ... Briggs, T; + view all (2017) The Role of Robotics in the Invasive Management of Bladder Cancer. Current Urology Reports , 18 , Article 57. 10.1007/s11934-017-0706-7. Green open access

[thumbnail of Kelly_ management of bladder cancer.pdf]
Preview
Text
Kelly_ management of bladder cancer.pdf - Accepted version

Download (653kB) | Preview

Abstract

Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique. For intracorporeal RARC (iRARC), this urinary reconstruction is performed robotically without further incisions. There are theoretical benefits to this approach such as reduced recovery time for the bowel and reduced ileus rates, but no level 1 evidence currently exists to support this. While there has been an improvement in patient outcomes since the adoption of RARC, various other factors, such as enhanced recovery programmes and surgical learning curve, have made it difficult to attribute this solely to the robotic approach as many centres performing ORC have also shown similar improvements. In this review, we will discuss implementation of RARC as well as perioperative measures that have helped improve outcomes, offer a comparison of outcomes between ORC and RARC and highlight upcoming RCTs that may offer new evidence for or against a paradigm shift in the future of bladder cancer surgery.

Type: Article
Title: The Role of Robotics in the Invasive Management of Bladder Cancer
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11934-017-0706-7
Publisher version: https://doi.org/10.1007/s11934-017-0706-7
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Urology & Nephrology, Robotic cystectomy, Intracorporeal, Extracorporeal, Bladder cancer, Enhanced recovery, ASSISTED RADICAL CYSTECTOMY, EXTRACORPOREAL URINARY-DIVERSION, ENHANCED RECOVERY PROGRAM, LEARNING-CURVE, LAPAROSCOPIC CYSTECTOMY, CUMULATIVE ANALYSIS, INITIAL-EXPERIENCE, COLORECTAL SURGERY, OUTCOMES, COMPLICATIONS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/1560871
Downloads since deposit
119Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item