{"title":"Case Report: Robot-assisted laparoscopic bladder diverticulectomy: a case series and initial experience.","authors":"Guangju Ge, Haihong Wang, Qiming Zheng, Shuai Zhang, Huan Wang, Liang Ma","doi":"10.3389/fsurg.2024.1453883","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To explore the experience of tumor control technique in robot-assisted laparoscopic bladder diverticulectomy (RALBD) in the treatment of bladder diverticulum tumor, intraoperative tumor control and postoperative comprehensive treatment.</p><p><strong>Patients and methods: </strong>We treated three male patients with bladder diverticulum tumors. Case 1 involved a 63-year-old with a 3.0 cm tumor in the diverticulum on the right bladder wall. Case 2 involved a 70-year-old with a 1.0 cm cauliflower-like tumor in the diverticulum on the left bladder wall. Case 3 involved a 64-year-old with a 3.0 cm tumor in the diverticulum on the right bladder wall. Each patient underwent robot-assisted laparoscopic partial cystectomy (PC) with ureteral Double J (D-J) stent placement. To minimize the risk of intraoperative tumor spread, we implemented enhanced surgical techniques. Systemic chemotherapy and adjuvant intravesical chemotherapy were recommended to reduce the risk of tumor recurrence and metastasis.</p><p><strong>Results: </strong>Postoperative pathology confirmed papillary urothelial carcinoma in all three cases. Each patient was followed up for over 20 months, with no evidence of recurrence or distant metastasis observed through cystoscopy and chest and abdominal CT scans.</p><p><strong>Conclusion: </strong>For patients with urothelial carcinoma in a bladder diverticulum, robot-assisted laparoscopic bladder-sparing surgery is a viable option when appropriate cases are selected. Effective intraoperative tumor control and comprehensive postoperative treatment are crucial to minimizing recurrence and metastasis risks. The robotic approach offers enhanced precision and visualization compared to traditional open or laparoscopic techniques, potentially leading to improved outcomes regarding intraoperative tumor control and reduced postoperative complications. However, this study is limited by its small sample size of only three patients and short-term follow-up. A larger sample of patients is needed to confirm the advantages of the robotic approach.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1453883"},"PeriodicalIF":1.6000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743490/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2024.1453883","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To explore the experience of tumor control technique in robot-assisted laparoscopic bladder diverticulectomy (RALBD) in the treatment of bladder diverticulum tumor, intraoperative tumor control and postoperative comprehensive treatment.
Patients and methods: We treated three male patients with bladder diverticulum tumors. Case 1 involved a 63-year-old with a 3.0 cm tumor in the diverticulum on the right bladder wall. Case 2 involved a 70-year-old with a 1.0 cm cauliflower-like tumor in the diverticulum on the left bladder wall. Case 3 involved a 64-year-old with a 3.0 cm tumor in the diverticulum on the right bladder wall. Each patient underwent robot-assisted laparoscopic partial cystectomy (PC) with ureteral Double J (D-J) stent placement. To minimize the risk of intraoperative tumor spread, we implemented enhanced surgical techniques. Systemic chemotherapy and adjuvant intravesical chemotherapy were recommended to reduce the risk of tumor recurrence and metastasis.
Results: Postoperative pathology confirmed papillary urothelial carcinoma in all three cases. Each patient was followed up for over 20 months, with no evidence of recurrence or distant metastasis observed through cystoscopy and chest and abdominal CT scans.
Conclusion: For patients with urothelial carcinoma in a bladder diverticulum, robot-assisted laparoscopic bladder-sparing surgery is a viable option when appropriate cases are selected. Effective intraoperative tumor control and comprehensive postoperative treatment are crucial to minimizing recurrence and metastasis risks. The robotic approach offers enhanced precision and visualization compared to traditional open or laparoscopic techniques, potentially leading to improved outcomes regarding intraoperative tumor control and reduced postoperative complications. However, this study is limited by its small sample size of only three patients and short-term follow-up. A larger sample of patients is needed to confirm the advantages of the robotic approach.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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