Robot Assisted Intracorporeal Urinary Diversion: Orthotopic Neobladder

Radical cystectomy with urinary diversion is the standard of care for muscle-invasive bladder cancer. It is associated with greater ergonomic comfort, magnification, lesser blood loss, and lesser pain with minimal incisions. Robotic cystectomy with orthotopic neobladder remains one of the most complex surgeries in urology, with high complication rates even in the hands of experienced surgeons. This book chapter describes a step-by-step Karolinska technique of the Struder neobladder, adapted from open surgery and refined over the last 20 years. Our experience with intracorporeal RARC demonstrates acceptable oncological and functional outcomes with this technique. A structured approach in each surgery can achieve a desirable functional outcome with minimum complications.