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Maqboul et al. Mini-invasive Surg 2021;5:44 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.54

Review Open Access

The contemporary status of robotic intracorporeal

neobladder

1
1,2
1
Fouad Maqboul , Johnraj Kishore Raja Thinagaran , Zach Dovey , Peter Wiklund 2
1
Department of Urology, Ashford and St. Peter’s Hospital NHS Trust Foundation, Chertsey, Surrey KT16 OPZ, UK.
2
Department of Urology, Mount Sinai Hospital, New York, NY 10029, USA.
Correspondence to: Dr. Zach Dovey, Department of Urology, Mount Sinai Hospital, Icahn Medical School 1, Gustav L. Levy Place,
New York, NY 10029, USA. E-mail: zachary.dovey@mountsinai.org
How to cite this article: Maqboul F, Thinagaran JKR, Dovey Z, Wiklund P. The contemporary status of robotic intracorporeal
neobladder. Mini-invasive Surg 2021;5:44. https://dx.doi.org/10.20517/2574-1225.2021.54

Received: 22 Apr 2021 First Decision: 22 Jun 2021 Revised: 8 Jul 2021 Accepted: 27 Jul 2021 First online: 3 Aug 2021

Academic Editor: Riccardo Autorino Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Robotic intracorporeal neobladder (RIN) is increasingly the modality of choice for intracorporeal urinary diversion
in high-volume Robotic Urology centers. This article details the modern technique of RIN, explains specific tips and
tricks to facilitate timely operative progression as well as weighs the outcomes from recently published series. An
OVID/EMBASE database search was done using keywords: robotic, cystectomy, intracorporeal neobladder,
orthotopic, and intracorporeal urinary diversion. The inclusion criteria were original studies on Robot-Assisted
Radical Cystectomy (RARC) with RIN series, available in full text in English, published over the last ten years with a
specific analysis of oncological and functional outcomes. Pooled data analysis of the 10 studies included shows
80% of patients had organ-confined disease (≤pT2), 1.86% of patients had positive surgical margin, median lymph
node yield of 23 nodes (IQR = 7.5), and cancer-specific survival rate of 78% (range 72%-100%) over a mean
follow up of 27.43 months (range 13-37 months). Functionally, the median day continence rate is 81.5%, night
continence rate is 61%, and rate of return to spontaneous sexual activity is 33.5%. This compares favorably with
outcomes of The International Robotic Cystectomy Consortium - Extracorporeal Urinary Diversion data and data
from open radical cystectomy (ORC) neobladder series with long term follow up. High-volume robotic centers have
successfully introduced programs for RARC, with RIN demonstrating its safety and feasibility. Their results suggest
potential to improve perioperative and functional outcomes over ORC. Moreover, under mentorship, surgeons can
learn the technique of RARC and RIN without these outcomes being significantly affected.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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