1. Robot-assisted Laparoscopic Radical Cystectomy KH Rha Severance Hospital Yonsei University The 10 th Catholic International Urology Symposium, 2008 13:30–14:50 Asian experiences of laparoscopic radical cystectomy

2. Robot-assisted Laparoscopic Radical Cystectomy Advantages surgeon comfort less learning curve (than lap surgery) advantages of minimally invasive surgery better outcome? Disadvantages lack of an effective force-feedback feature more cumbersome robotic installation relative high cost

3. Between April 2007 and April 2008 6 men, 3 women RLRC were performed with the da Vinci™ robot system with four robot arms. The specimen was extracted through the subumbilical incision. The ICUD was achieved through a removal site of a specimen by extracorporeal technique. Robot-assisted Laparoscopic Radical Cystectomy in Yonsei

4. 17cm 8cm ● 5mm port ■ 8mm port ▲ 12mm port 2-3cm Port Placement

5. Robot-assisted Laparoscopic Radical Cystectomy in Yonsei

6. Results Mean operative time: 379.8 ± 77.8 min Mean estimated blood loss: 611.1 ± 431.4 ml No major intraoperative complication One open conversion due to severe adhesion Robot-assisted Laparoscopic Radical Cystectomy in Yonsei

7. Pathologic stageNumber of patients Positive Margins T0/Ta/Tis3- T1/T23- T31- T42-

8. Results Mean number of LN dissected: 16.4 ± 7.7 (range: 12–28) Mean hospital stay: 10.3 ± 2.8 days Mean soft diet start: 5.4 ± 1.7 days Robot-assisted Laparoscopic Radical Cystectomy in Yonsei

9. Robot-assisted radical cystectomy with pelvic lymph node dissection can be safely performed in patients who are candidates for open cystectomy Long term oncological results and QOL outcomes will define its position in minimally invasive urologic oncology Conclusion

10. Thank you for attention.