Robotic-assisted intracorporeal radical cystectomy with modified ileal conduit reduces ureteroileal anastomotic stenosis risk: a comparative study with laparoscopic surgery.

BACKGROUND

This study aims to evaluate the clinical efficacy of an innovative robot-assisted totally intracorporeal antecolic modified ileal conduit procedure (robotic group) versus laparoscopic surgery (laparoscopic group) in bladder cancer patients, providing evidence for optimizing urinary diversion strategies and reducing associated complications.

METHODS

From Jan 2023 to Oct 2025, 69 patients undergoing total cystectomy by one surgeon were enrolled; 23 received robotic surgery (KangDuo SR2000) and 46 laparoscopic. Baseline, perioperative, and postoperative data were collected. Primary endpoint: radiologically confirmed ureteroileal anastomotic stenosis; secondary: postoperative ileus, new upper urinary tract stones, 90‑day complications, and recovery indicators.

RESULTS

Baseline characteristics were similar between groups (all p > 0.05). The robotic group had significantly lower stenosis (0% vs 15.22%, p = 0.043), ileus (8.70% vs 28.26%, p = 0.043), and new stones (4.35% vs 21.74%, p = 0.046). Intraoperative blood loss was reduced (98.70±28.97 vs 155.00±65.76 mL, p < 0.001), but operative time was longer (249.7±19.7 vs 199.6±22.7 min, p < 0.001). No significant differences were found in time to bowel function recovery or 90‑day complication rate.

CONCLUSION

Robot‑assisted intracorporeal radical cystectomy with modified ileal conduit ensures perioperative safety, lowers long‑term complications and blood loss despite longer operative time, suggesting it is a promising alternative; however, prospective randomized controlled trials are needed to confirm these findings.