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

In brief

Robotic intracorporeal cystectomy eliminates ureteroileal stenosis versus 15% after laparoscopy

In a single-surgeon series of 69 bladder-cancer patients, the robot-assisted totally intracorporeal ileal conduit showed no anastomotic stenoses, compared with a 15% rate in the laparoscopic group, and also reduced ileus, new stones, and intra-operative blood loss, though surgery took about 50 minutes longer. Larger randomized trials are needed to confirm these advantages.

Journal
Annals of medicine (Q1)
Published
29 July 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Tengfei Gu, Roberta Gunelli, Ting Chen, Chen Wang, Yongtao Pan, Qinzhou Yu, et al.
PMID
42525819
DOI
10.1080/07853890.2026.2703361

Why clinicians should know about it

Abstract

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.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.