Recent advances in robot-assisted radical cystectomy.

PURPOSE OF REVIEW: The prevalence of robot-assisted radical cystectomy is steadily increasing. We review the recent literature evaluating this technique as a minimally invasive alternative to open radical cystectomy for the treatment of bladder cancer. RECENT FINDINGS: Within the last year, numerous robot-assisted radical cystectomy case series with larger cohorts have been published, providing new insights regarding perioperative morbidity and early oncologic outcomes. With appropriate experience, this procedure offers the potential benefits of decreased blood loss and transfusion rates, reduced analgesic requirements, and shorter hospital stay relative to the open approach. Recent data from a nonrandomized study demonstrate fewer postoperative complications with robot-assisted radical cystectomy. Short-term oncologic outcomes in the absence of patient selection appear to be equivalent to contemporary open radical cystectomy series. A small prospective, randomized trial comparing open and robotic radical cystectomy demonstrated equivalent lymph node yields. SUMMARY: Robot-assisted radical cystectomy is an emerging minimally invasive approach to radical cystectomy. Early data suggest potential benefits in perioperative morbidity with equivalent short-term oncologic outcomes as compared with open radical cystectomy. Long-term follow-up and larger prospective, randomized comparisons with open radical cystectomy are needed as this technique continues to be evaluated.