Robotic bladder diverticulectomy in patients with bladder diverticulum neoplasia: a single-center study

Purpose: The aim of this work is to present the clinical experience and outcomes in the management and follow up of bladder diverticular neoplasm. Methods: Following institutional board approval and informed consent obtained from each patient, a total of 10 patients, from January 2021 to December 2023, underwent robotic assisted bladder diverticulectomy with the preservation of the bladder. All the cases were performed with a four port transperitoneal approach plus two laparoscopic ports for the second surgeon, opting for an extravesical dissection of the diverticular neck. A tailored follow up for each patient was planned with cytological examination, cystoscopy and imaging. All patients were screened to confirm localized disease and to exclude obstructive disease and LUTS to avoid high post voiding volumes. Results: To date, all patients involved in the study have adhered to the follow up protocol and remain alive and free of recurrent disease. Catheters were successfully removed in all ten patients, after a negative cystography for leakage at seven days. Pathological examination confirmed clear surgical margins in 100% of the cases. The average length of the procedure was 112 minutes, with minimal blood loss and a mean hospital stay of 3, 7 days. No major complication occurred. Conclusions: Our case series demonstrated the safety and feasibility of this approach, achieving favourable operative times, minimal blood loss and absence of leakage. The outcomes also highlight improvement in terms of reduction of catheterization duration, hospital stay and QoL of the patients.