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COMPARATIVE OUTCOMES & COMPLICATIONS OF ROBOTIC VS OPEN
CYSTOPLASTY
Mohan GUNDETI
1
, Andrew COHEN
2
, Prithvi MURTHY
3
, Katie BRODIE
4
and Duncan WILCOX
4
1) University of Chicago, Section of Urology, The University of Chicago Medicine: Comer Childrens' Hospital, Chicago,
USA - 2) University of Chicago, Urology, Chicago, USA - 3) University of Chicago, Pritzker School of Medicine, Chicago,
USA - 4) University of Colorado, Division of Urology, Department of Surgery, Aurora, USA
PURPOSE
To compare perioperative and surgical outcomes in a two center two surgeon open vs. robotic
augmentation
ileocystoplasty (with catheterizable channels and bladder neck procedures as required). We previously demonstrated
the feasibility and safe application of robotic laparoscopic approach for cystoplasty and complex reconstructions;
herewith we are further critically appraising the outcomes.
MATERIAL AND METHODS
We reviewed patients undergoing augmentation ileocystoplasty open vs. robotically by two similarly trained and
experienced surgeons between 2008 and 2014 at two centers. The groups were compared in respect to preoperative
characteristics, perioperative outcomes, complications, and interim functional outcomes.
RESULTS
The cohort consisted of 17 and 15 patients with median follow up 45 and 32 months, in open and robotic groups,
respectively. See data table. In addition to morphine equivalents, 4/17 (23.5%) of the open cohort had an epidural for
average of 93 hours versus 0 in the robotic cohort. All patients had stable or improved postoperative hydronephrosis by
ultrasound.
Characteristic
Open (n=17)
Robotic (n=15)
p value
Age, years (range)
8.0(3.0-20)
11.7(7.4-25.6)
0.052
Body mass index (kg/m^2) (95%CI)
18.8(16.0-21.7)
22.0(17.8-26.1)
0.219
Concomitant Procedures
17(100%)
14(93%)
-
Operative Time, min (IQR)
265(232-304)
683(635-713)
<0.001
Estimated Blood Loss, mL (95%CI)
84.5(49.5-119.5)
113 (66-160.6)
0.338
IV Morphine Equivalents, mg/kg (95%CI) 1.23(0.55-1.9)
0.56(0.328-0.79)
0.091
Return to Full Diet, days (IQR)
4(3-6)
4(3-5)
0.834
Median length of stay (IQR)
7(5.5-8.5)
(5-8)
0.675
Major Reoperations
2(11.7%)
0
-
Stomal Complications
0
4(23.5%)
-
CONCLUSIONS
While incurring longer operative times, robotic
augmentation ileocystoplasty demonstrates similar post-operative
recovery and complications. More study is needed prior to widespread adoption of this robotic technique.