Category: Robotic Surgery: Lower Tract - Benign
Introduction & Objective :
Diverticulectomy may be indicated in the management of large bladder diverticulum due to repeated infection. This can be achieved with minimally invasive techniques using pure laparoscopy or robotic assistance, depending on the complexity of anatomy such as a ureteric insertion within the diverticulum.
Four consecutive cases of minimally invasive bladder diverticulectomy within the past 12 months by a single surgeon were reviewed. We selected a rare case of a patient with recurrent infection due to large bladder diverticulum secondary to previous urethral stricture which had been treated. The diverticulum neck was located near the left trigone, with the left ureter inserting within the diverticulum. The patient underwent a robot-assisted bladder diverticulectomy and reimplantation of his left ureter. We present the surgical technique of this case and our clinical outcomes.
Robot-assisted bladder diverticulectomy and reimplantation of left ureter was performed with flexible cystoscopic guidance. Preoperative cystoscopy was used to located the left ureteric orifice and the left ureter was stented. Of the 4 cases of robotic/laparoscopic diverticulectomy, the mean EBL was 137.5 mls and operative time was 275 min. There were no intraoperative complications and the median length of stay was 3 days. Median catheter days was 9.
Bladder diverticulectomy can be performed with either laparoscopic or robotic assistance, depending on the complexity of the anatomy.