V08-07 PERIOPERATIVE AND FUNCTIONAL RESULTS OF RARC WITH TOTALLY INTRACORPOREAL NEOBLADDER: THE VES.PA. TECHNIQUE. IDEAL STAGE 2a REPORT

You have accessJournal of UrologyBladder & Urothelial Upper Tract Oncology (V08)1 May 2024V08-07 PERIOPERATIVE AND FUNCTIONAL RESULTS OF RARC WITH TOTALLY INTRACORPOREAL NEOBLADDER: THE VES.PA. TECHNIQUE. IDEAL STAGE 2a REPORT Fabrizio Dal Moro, Fabio Zattoni, Elisa Toner, Alessandro Morlacco, Giovanni Betto, and Giacomo Novara Fabrizio Dal MoroFabrizio Dal Moro , Fabio ZattoniFabio Zattoni , Elisa TonerElisa Toner , Alessandro MorlaccoAlessandro Morlacco , Giovanni BettoGiovanni Betto , and Giacomo NovaraGiacomo Novara View All Author Informationhttps://doi.org/10.1097/01.JU.0001009440.59296.9f.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted radical cystectomy (RARC) has been shown to offer several advantages over open surgery, including reduced blood loss, lower transfusion rates, and shorter hospital stays. Intracorporeal neobladder reconstruction is an emerging technique that offers several benefits over extracorporeal reconstruction, including a reduction in the number of incisions and a shorter time to recovery. The Ves.Pa. refinement technique is a modification of the original approach that simplifies the procedure and reduces the risk of complications. Aim of the study is to report the Ideal stage 2a for RARC with intracorporeal neobladder reconstruction according to the Ves.Pa. refinement technique. METHODS: Consecutive patients prospectively treated by a single surgeon with RARC and Ves.Pa. for muscle-invasive or non-muscle invasive, BCG refractory urothelial bladder cancer in a tertiary referral center. The Ves.Pa. technique involves intracorporeal suturing of the ureters, bladder neck, and neobladder without the use of a stapler. The technique also avoids the use of a funnel configuration of the bladder neck and ensures that the ureters are reimplanted on their respective sides. The study assessed the feasibility, safety, and oncological and functional outcomes of RARC with Ves.Pa. neobladder. Complications were classified using the Clavien-Dindo classification system, and functional outcomes were assessed using validated questionnaires. RESULTS: A total of 21 patients underwent RARC with Ves.Pa. refinement technique for a totally intracorporeal neobladder. The median operative time was 375 minutes, and the median estimated blood loss was 400 ml. The prevalence of high-grade complications was extremely low, with only one patient experiencing a Clavien-Dindo grade IIIa complication. All patients had clear surgical margins. At the median follow-up of 12 months, patients had a median AUA-SI score of 8 and no one required intermittent catheterization. Urinary incontinence (ICIQ-UI) was reported moderate and severe in respectively 10 (48%) and 7 (33%). Only 19% did not wear pads at night. Of the male patients, median IIEF-5 score was 16 (IQR 12-19) at available follow up. The study is limited by its small sample size, single-center design, and short follow-up duration. CONCLUSIONS: The RARC with a Ves.Pa. refinement technique for a totally intracorporeal neobladder reconstruction is safe, feasible and replicable. The technique simplifies the procedure and reduces the risk of complications. The study's results suggest acceptable oncological and functional outcomes at the available follow-up. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e558 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fabrizio Dal Moro More articles by this author Fabio Zattoni More articles by this author Elisa Toner More articles by this author Alessandro Morlacco More articles by this author Giovanni Betto More articles by this author Giacomo Novara More articles by this author Expand All Advertisement PDF downloadLoading ...