Evolution of robot-assisted orthotopic ileal neobladder formation: a step-by-step update to the University of Southern California (USC) technique
To describe our, step-by-step, technique for robotic intracorporeal neobladder formation.
Patients and Methods
The main surgical steps to forming the intracorporeal orthotopic ileal neobladder are: isolation of 65 cm of small bowel; small bowel anastomosis; bowel detubularisation; suture of the posterior wall of the neobladder; neobladder–urethral anastomosis and cross folding of the pouch; and uretero-enteral anastomosis. Improvements have been made to these steps to enhance time efficiency without compromising neobladder configuration.
Our technical improvements have resulted in an improvement in operative time from 450 to 360 min.
We describe an updated step-by-step technique of robot-assisted intracorporeal orthotopic ileal neobladder formation.