Enhanced Recovery Protocols (ERP) in Robotic Cystectomy Surgery. Review of Current Status and Trends

Christofer Adding, Justin W. Collins, Oscar Laurin, Abolfazl Hosseini, N. Peter Wiklund

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Open radical cystectomy with pelvic lymphadenectomy and urinary diversion is associated with a high complication rate. Robotic-assisted laparoscopic radical cystectomy is increasingly performed in many urologic surgical departments in an effort to reduce surgical stress and decrease perioperative morbidity. Robotic cystectomy survival studies demonstrate similar oncologic outcomes compared to the open procedure. Enhanced recovery protocols (ERP) after major surgery are multimodal perioperative interventions to reduce surgical stress, complications, and patient convalescence. Evidence for different ERP interventions are currently mainly from colorectal surgery and recently adapted to major urologic operations including cystectomy. Guidelines for perioperative care after open radical cystectomy for bladder cancer were recently published, but these recommendations may differ when considering a robotic approach. Therefore, we look at the current evidence for ERP in both open and robotic radical cystectomy and the potential for improving ERPs in robotic cystectomy by utilizing a totally intracorporeal robotic cystectomy approach. We also present the Karolinska ERP currently utilized in totally intracorporeal robotic cystectomy.

Original languageEnglish
JournalCurrent Urology Reports
Volume16
Issue number5
DOIs
StatePublished - 1 May 2015
Externally publishedYes

Keywords

  • Open radical cystectomy
  • Pelvic lymphadenectomy
  • Robotic-assisted laparoscopic radical cystectomy
  • Urinary diversion
  • Urosurgery

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