Robot-assisted radical cystectomy: The MD Anderson approach

Radical cystectomy with pelvic lymphadenectomy is among the most morbid procedures performed by urologists, despite it being the mainstay of therapy for patients with muscle invasive and recurrent T1 high-grade bladder cancer. The robot-assisted approach has been shown to have oncologic non-inferiority to open radical cystectomy in several randomized controlled trials, along with modest improvements in hospital length of stay, decreased blood loss, and decreased transfusion requirements. With appropriate experience, careful patient selection, and a team-centered surgical approach involving preoperative patient counseling, coordination with anesthesiology, and incorporation of enhanced recovery after surgery pathways, the robot-assisted minimally invasive technique can offer excellent outcomes for patients requiring radical cystectomy.