Robotic Radical Cystoproatatectomy and Intracorporeal Neobladder

FDA approved the Da Vinci Surgical System in 2000 for clinical usage, and robotic assisted radical prostatectomy was performed in the same year. With the prevailing of robot-assisted laparoscopic radical prostatectomy, urologist realized the advantages of performing complicated pelvic surgeries with robotic surgical system, and thus ventured into robotic assisted radical cystectomy. Wolfram et al. first reported robot-assisted laparoscopic radical cystectomy and intracorporeal neobladder in 2003.Menon was the first person who standardized the procedure of robotic assisted radical cystectomy (RARC). First, a transverse incision was made near the bottom of rectovesical pounch, vas deferens and seminal vesicle gland was mobilized A transverse incision was made to open Denonvilliers Fascia, seminal vesicle gland and vas deferens ampulla were retracted with the bladder. Anterior wall of rectum was separated from prostate until apex. Subsequently, peritoneum was incised and dissected at the avascular plane to identify bilateral ureters at iliac arteries bifurcation. Both ureters were dissected down to trigone. Bilateral superior vesical arteries were divided, Peritoneum was incised next to lateral lateral umbilical ligament, Prevesical space was separated, puboprotatic ligament was divided, bladder and prostate were mobilized.