Prevention and management of complications following robot-assisted radical cystectomy: lessons learned after >250 consecutive cases

Abstract

An increasing number of case series of robot-assisted radical cystectomy describe complication rates comparable to open series. Conflicting reports describe various pre-operative factors as predictors of post-operative complications. Furthermore, learning curves complicate these predictors and should also be taken into account. Despite these variables, there are a number of considerations, including patient selection, peri-operative care pathway, intra-operative technique and equipment choice that we have found to decrease post-operative complications and improve patient outcomes. In this topic paper, we briefly review the literature surrounding complication rates following robot-assisted radical cystectomy as well as describe our experience after >250 cases, outlining our suggestions for avoidance of surgical complications when building a practice that incorporates this technique.