Robotic intracorporeal urinary diversion: ileal conduit. 2012

David Johnson, and Erik Castle, and Raj S Pruthi, and Michael E Woods
Division of Urologic Surgery, The University of North Carolina, Chapel Hill, NC, USA.

Radical cystectomy is considered the standard of care for muscle-invasive bladder cancer. The use of minimally invasive techniques, particularly robot-assisted radical cystectomy, is steadily increasing with an acceptable learning curve, adequate lymph node yield, and acceptable perioperative complications. Longer-term follow-up is necessary to confirm oncologic efficacy, but early data are encouraging. While the majority of urinary diversions are performed extracorporeally, several recent small case studies have reported successful totally intracorporeal diversions, including both ileal conduit and orthotopic neobladder creation. Operative and short-term clinical outcomes have thus far been comparable to those of previously reported extracorporeal techniques. As surgeons gain experience with the robotic techniques needed for radical cystectomy, the frequency of intracorporeal urinary diversions will similarly increase. In this article, we describe the stepwise surgical procedure and perioperative management of the robot-assisted laparoscopic intracorporeal ileal conduit.

UI MeSH Term Description Entries
D007082 Ileum The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000714 Anastomosis, Surgical Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side. Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D012371 Robotics The application of electronic, computerized control systems to mechanical devices designed to perform human functions. Formerly restricted to industry, but nowadays applied to artificial organs controlled by bionic (bioelectronic) devices, like automated insulin pumps and other prostheses. Companion Robots,Humanoid Robots,Remote Operations (Robotics),Social Robots,Socially Assistive Robots,Telerobotics,Soft Robotics,Assistive Robot, Socially,Companion Robot,Humanoid Robot,Operation, Remote (Robotics),Operations, Remote (Robotics),Remote Operation (Robotics),Robot, Companion,Robot, Humanoid,Robot, Social,Robot, Socially Assistive,Robotic, Soft,Social Robot,Socially Assistive Robot,Soft Robotic
D014513 Ureter One of a pair of thick-walled tubes that transports urine from the KIDNEY PELVIS to the URINARY BLADDER. Ureters
D014547 Urinary Diversion Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654) Ileal Conduit,Conduit, Ileal,Conduits, Ileal,Diversion, Urinary,Diversions, Urinary,Ileal Conduits,Urinary Diversions
D015607 Stents Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting. Stent
D055805 Moving and Lifting Patients Moving or repositioning patients within their beds, from bed to bed, bed to chair, or otherwise from one posture or surface to another. Patient Moving and Lifting,Patient Handling,Patient Lifting,Patient Moving,Patient Repositioning,Handling, Patient,Handlings, Patient,Lifting, Patient,Liftings, Patient,Moving, Patient,Movings, Patient,Patient Handlings,Patient Liftings,Patient Movings,Patient Repositionings,Repositioning, Patient,Repositionings, Patient

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