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• W2795526704 abstract "You have accessJournal of UrologyBladder Oncology & Diversion1 Apr 2018V05-12 FLORENCE ROBOTIC INTRACORPOREAL NEOBLADDER (FLORIN). A NEW CONFIGURATION USING STRATEGY DEVELOPED FOLLOWING THE IDEAL GUIDELINES Andrea Minervini, Davide Vanacore, Simone Sforza, Francesco Sessa, Riccardo Campi, Andrea Mari, Martina Milanesi, Fabrizio Di Maida, Giovanni Tasso, Andrea Cocci, Agostino Tuccio, Gianni Vittori, Giampaolo Siena, and Marco Carini Andrea MinerviniAndrea Minervini More articles by this author , Davide VanacoreDavide Vanacore More articles by this author , Simone SforzaSimone Sforza More articles by this author , Francesco SessaFrancesco Sessa More articles by this author , Riccardo CampiRiccardo Campi More articles by this author , Andrea MariAndrea Mari More articles by this author , Martina MilanesiMartina Milanesi More articles by this author , Fabrizio Di MaidaFabrizio Di Maida More articles by this author , Giovanni TassoGiovanni Tasso More articles by this author , Andrea CocciAndrea Cocci More articles by this author , Agostino TuccioAgostino Tuccio More articles by this author , Gianni VittoriGianni Vittori More articles by this author , Giampaolo SienaGiampaolo Siena More articles by this author , and Marco CariniMarco Carini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1399AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To describe our step-by-step technique for robotic intracorporeal neobladder configuration, including the stages of conception, development and exploration of this surgical innovation, according to the IDEAL Collaboration guidelines. METHODS FloRIN neobladder was performed after the following main surgical steps: isolation of 50 cm of ileum; bowel anastomosis; urethro-ileal anastomosis creating an asymmetrical U shape (30 cm distally and 20 cm proximally to anastomosis), ileum detubularisation; posterior wall reconfiguration as an L; bladder neck reconstruction; anterior folding of the posterior plate to reach the 12 o'clock position; uretero-enteral orthotopic bilateral anasthomosis. The idealization and development of FloRIN followed IDEAL guidelines recommended stages: Phase 1 (simulation) consisted in the neobladder robotic configuration on silicone models. Phase 2a (development) aimed to reproduce the configuration in an open fashion in one patient, and then in the first three robotic procedures. Phase 2b (exploration) consisted of the technique standardization in ten consecutive robotic approaches. Phase 2a and 2b included urodynamical and imaging assessment of patients treated. RESULTS From February 2016 to September 2017 FloRIN was performed in 18 patients. Comparing the first 3 (Phase 2a) with the subsequent 15 patients (Phase 2b), the median (interquartiles) reconstruction operating time was 260 (220-340) vs 160 (150-210) min, respectively. Postoperative complications occurred in 4/18 (22.1%) patients, including one surgical Clavien 3 and three medical Clavien 2, respectively. The urodynamic examination (available in 9 [50%] patients) showed median (interquartiles) reservoir cystometric capacity, compliance, and post-void residual of 240 (220-267) mL, 18 (12.5-19.8) ml/cmH2O, and 0 (0-50) mL, respectively. Ultrasound showed no Grade =2 vesicoureteral reflux. CONCLUSIONS We describe FloRIN neobladder, concluding its technical feasibility with acceptable time efficiency. The first cases studied showed good reservoirs capacity, low pressure with no reflux, and complete voiding. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e576 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrea Minervini More articles by this author Davide Vanacore More articles by this author Simone Sforza More articles by this author Francesco Sessa More articles by this author Riccardo Campi More articles by this author Andrea Mari More articles by this author Martina Milanesi More articles by this author Fabrizio Di Maida More articles by this author Giovanni Tasso More articles by this author Andrea Cocci More articles by this author Agostino Tuccio More articles by this author Gianni Vittori More articles by this author Giampaolo Siena More articles by this author Marco Carini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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