RESUMO
PURPOSE: This case series describes the experience and outcomes of multiple Australian surgeons performing robotic-assisted bladder diverticulectomy (RABD), highlighting the procedural effectiveness and safety, for both benign and malignant indications for diverticulectomy. METHODS: Outcomes were analysed from Thirteen experienced Australian urologists who performed RABD between 2016 and 2023. Retrospective analysis was performed on prospectively collected data which included patient demographics, diverticulum characteristics, surgical approaches, and post-operative outcomes. Surgical techniques included the extravesical and intravesical approaches, with the focus on maintaining oncological principles in cases of malignancy. RESULTS: A total of 28 patients underwent RABD, with the majority being male and a mean age of 63.9 years. All surgeons utilised a four port transperitoneal approach and opted for the extravesical dissection of the diverticular neck, one case utilised both extravesical and a trans-diverticular approach. Functional outcomes demonstrated symptomatic resolution in patients with non-malignant diverticula, while oncological outcomes indicated clear margins in 90% of malignant cases. The average length of the procedure was 106 minutes, with minimal blood loss and a mean hospital stay of 2.67 days. Early complications occurred in 14% with the majority Clavien-Dindo grade II . CONCLUSION: Robotic bladder diverticulectomy, predominantly via the transperitoneal extravesical approach, has emerged as a safe, effective, and reliable surgical intervention for both malignant and non-malignant bladder diverticula. The consistent surgical approach and excellent outcomes demonstrated in this case series reinforce the procedure's potential as a safe option, even in the setting of malignancy within a diverticulum.
