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Transvesical approach in robot-assisted bladder diverticulectomy : surgical technique and outcome

Dries Develtere, Elio Mazzone, Camille Berquin (UGent) , Céline Sinatti, Ralf Veys, Rui Farinha, Elisabeth Pauwels, Peter Schatteman, Ruben De Groote, Frederiek D'Hondt, et al.
(2022) JOURNAL OF ENDOUROLOGY. 36(3). p.313-316
Author
Organization
Abstract
Objective: Treatment for bladder diverticula may become necessary in case of incomplete bladder emptying or recurrent urinary tract infections (UTIs). When bladder outlet obstruction is present, a simultaneous desobstructive procedure can be performed. In this video, we present our technique for a transvesical approach in robot-assisted bladder diverticulectomy (RABD) and discuss its outcomes.Patients and Surgical Procedure: We retrospectively analyzed the outcomes of 23 patients who underwent a transvesical RABD between March 2015 and May 2020 at the OLV hospital of Aalst. After retrograde filling, a cystotomy is performed. The orifices are identified and the bladder diverticulum is observed. The mucosa covering the diverticular neck is incised and the plane between the mucosa and the muscularis is identified. The mucosa is separated from the surrounding structures. The base of the diverticulum is transected using cautery. The defect is closed with a barbed suture.Results: Median age was 66 years (interquartile range [IQR] 60-69). The number of diverticula removed ranged from 1 to 3. Ten patients were treated with diverticulectomy alone, 12 underwent a simultaneous adenomectomy, 1 a radical prostatectomy. Median operative was 140 minutes (IQR 120-180), median estimated blood loss was 250 mL (IQR 28-438). Median catheterization time was 2 days (IQR 1-5), median hospitalization time 3 days (IQR 2-4). One patient developed urinary leakage after catheter removal, one patient developed a UTI. Median follow-up was 9 months (IQR 3.5-14). No late postoperative complications nor relapse were recorded. Average postvoid residual was 42 mL (IQR 0-111), with a median decline of 120 mL (IQR -402 to -33).Conclusions: Transvesical approach for RABD is a safe and reliable technique that gives the advantage of a quick localization of the diverticulum and orifices, and direct access to the prostate when simultaneous desobstruction is necessary. Catheterization time is short. No relapse has been observed.
Keywords
Urology, robotic surgery, bladder diverticulum, surgical technique, bladder diverticulectomy, MANAGEMENT

Citation

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MLA
Develtere, Dries, et al. “Transvesical Approach in Robot-Assisted Bladder Diverticulectomy : Surgical Technique and Outcome.” JOURNAL OF ENDOUROLOGY, vol. 36, no. 3, 2022, pp. 313–16, doi:10.1089/end.2021.0366.
APA
Develtere, D., Mazzone, E., Berquin, C., Sinatti, C., Veys, R., Farinha, R., … Mottrie, A. (2022). Transvesical approach in robot-assisted bladder diverticulectomy : surgical technique and outcome. JOURNAL OF ENDOUROLOGY, 36(3), 313–316. https://doi.org/10.1089/end.2021.0366
Chicago author-date
Develtere, Dries, Elio Mazzone, Camille Berquin, Céline Sinatti, Ralf Veys, Rui Farinha, Elisabeth Pauwels, et al. 2022. “Transvesical Approach in Robot-Assisted Bladder Diverticulectomy : Surgical Technique and Outcome.” JOURNAL OF ENDOUROLOGY 36 (3): 313–16. https://doi.org/10.1089/end.2021.0366.
Chicago author-date (all authors)
Develtere, Dries, Elio Mazzone, Camille Berquin, Céline Sinatti, Ralf Veys, Rui Farinha, Elisabeth Pauwels, Peter Schatteman, Ruben De Groote, Frederiek D’Hondt, Geert De Naeyer, and Alexandre Mottrie. 2022. “Transvesical Approach in Robot-Assisted Bladder Diverticulectomy : Surgical Technique and Outcome.” JOURNAL OF ENDOUROLOGY 36 (3): 313–316. doi:10.1089/end.2021.0366.
Vancouver
1.
Develtere D, Mazzone E, Berquin C, Sinatti C, Veys R, Farinha R, et al. Transvesical approach in robot-assisted bladder diverticulectomy : surgical technique and outcome. JOURNAL OF ENDOUROLOGY. 2022;36(3):313–6.
IEEE
[1]
D. Develtere et al., “Transvesical approach in robot-assisted bladder diverticulectomy : surgical technique and outcome,” JOURNAL OF ENDOUROLOGY, vol. 36, no. 3, pp. 313–316, 2022.
@article{8751051,
  abstract     = {{Objective: Treatment for bladder diverticula may become necessary in case of incomplete bladder emptying or recurrent urinary tract infections (UTIs). When bladder outlet obstruction is present, a simultaneous desobstructive procedure can be performed. In this video, we present our technique for a transvesical approach in robot-assisted bladder diverticulectomy (RABD) and discuss its outcomes.Patients and Surgical Procedure: We retrospectively analyzed the outcomes of 23 patients who underwent a transvesical RABD between March 2015 and May 2020 at the OLV hospital of Aalst. After retrograde filling, a cystotomy is performed. The orifices are identified and the bladder diverticulum is observed. The mucosa covering the diverticular neck is incised and the plane between the mucosa and the muscularis is identified. The mucosa is separated from the surrounding structures. The base of the diverticulum is transected using cautery. The defect is closed with a barbed suture.Results: Median age was 66 years (interquartile range [IQR] 60-69). The number of diverticula removed ranged from 1 to 3. Ten patients were treated with diverticulectomy alone, 12 underwent a simultaneous adenomectomy, 1 a radical prostatectomy. Median operative was 140 minutes (IQR 120-180), median estimated blood loss was 250 mL (IQR 28-438). Median catheterization time was 2 days (IQR 1-5), median hospitalization time 3 days (IQR 2-4). One patient developed urinary leakage after catheter removal, one patient developed a UTI. Median follow-up was 9 months (IQR 3.5-14). No late postoperative complications nor relapse were recorded. Average postvoid residual was 42 mL (IQR 0-111), with a median decline of 120 mL (IQR -402 to -33).Conclusions: Transvesical approach for RABD is a safe and reliable technique that gives the advantage of a quick localization of the diverticulum and orifices, and direct access to the prostate when simultaneous desobstruction is necessary. Catheterization time is short. No relapse has been observed.}},
  author       = {{Develtere, Dries and Mazzone, Elio and Berquin, Camille and Sinatti, Céline and Veys, Ralf and Farinha, Rui and Pauwels, Elisabeth and Schatteman, Peter and Groote, Ruben De and D'Hondt, Frederiek and Naeyer, Geert De and Mottrie, Alexandre}},
  issn         = {{0892-7790}},
  journal      = {{JOURNAL OF ENDOUROLOGY}},
  keywords     = {{Urology,robotic surgery,bladder diverticulum,surgical technique,bladder diverticulectomy,MANAGEMENT}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{313--316}},
  title        = {{Transvesical approach in robot-assisted bladder diverticulectomy : surgical technique and outcome}},
  url          = {{http://doi.org/10.1089/end.2021.0366}},
  volume       = {{36}},
  year         = {{2022}},
}
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