Three Early Cases of Robot-Assisted Radical Cystectomy and Perioperative Management Using a Clinical Pathway

Robot-assisted radical cystectomy was performed in three patients with bladder cancer. Urinary diversion was extracorporeal with ileal conduit. All three patients were men; two were in their 60s and one was in his 70s. Two patients underwent urethrectomy. The patients were perioperatively managed according to a clinical pathway. We investigated the validity of the clinical pathway for patients undergoing robot-assisted radical cystectomy. Perioperative data (surgical time, amount of bleeding, transfusion requirement, and complications) were investigated, and critical indicators (drinking and eating before surgery; drinking, eating, sitting, walking, completion of drip infusion, and discharge after surgery) were evaluated. Urinary tract infection was observed in one patient. All three patients achieved the target levels of all critical indicators, demonstrating the validity of the clinical pathway for perioperative management of patients undergoing robot-assisted radical cystectomy. Use of a postoperative recovery enhancement program in the perioperative management of patients undergoing radical cystectomy has attracted attention in recent years,. The clinical pathway for patients undergoing radical cystectomy should be revised taking promises of ERAS into consideration.