Perioperative Management of Robotic-Assisted Radical Cystectomy

Radical cystectomy (RC) is associated with significant morbidity and prolonged length of stay irrespective of surgical approach (Novara et al., Eur Urol 67(3):376, 2015; Gandaglia et al., Can Urol Assoc J 8(9–10):681, 2014). Enhanced recovery programs (ERPs) aim to improve surgical outcomes by reducing variation in perioperative best practices. There is randomized data evaluating the impact of ERPs on patients undergoing radical cystectomy which concludes that they reduce the length of stay in hospital, time-to-bowel function, all without affecting complication rates after cystectomy (Vlad et al., Medicine (Baltimore) 99(27):e20902, 2020; Frees et al., World J Urol 36(2):215, 2018; Lin et al., World J Urol 36(1):41, 2018; Karl et al., J Urol 191(2):335, 2014). Since publication of the EAU robotic urology scientific working group consensus views on ERPs after cystectomy (Collins et al., Eur Urol 70(4):649, 2016) there have been updates to the literature and further developments in ERPs, which are outlined in this article.