Robot-assisted orthotopic “W” ileal neobladder in male patients: step-by-step video-illustrated technique and preliminary outcomes

The objective was to describe our step-by-step technique for robot-assisted orthotopic “W” ileal neobladder (INB) for urinary diversion following radical cystectomy for oncological purpose, and to report the outcomes of this technique for the first six male patients treated at our center. Patients underwent robot-assisted radical cystoprostatectomy for bladder cancer and had a “W” ileal neaobladder as urinary diversion. Our surgical technique is described step by step and video illustrated. Patients and operative data were collected and reported. The Expanded Prostate Cancer Index Composite Short Form (EPIC-26) self-administered questionnaire was used to assess the urinary, sexual and bowel functions outcomes at 90 days postoperatively. The mean operative time was 475 min [420–525] and mean length of stay was 13 days [11–15]. No major complications occurred (Clavien grade ≥ 3). Regarding the continence four patients reported they leaked urine rarely or never and two patients having urine leak once a day. Two patients did not wear any pad, the four others reported using pad at night. Two patients reported urinary function as not a problem, one as a very small problem, two as a small problem and one as a moderate problem. These results from our six first cases using the technique described here are promising with interesting early functional outcomes. This has to be confirmed on larger cohort and with long-term follow-up.