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Robot-assisted neobladder yields better perioperative and functional outcomes with similar long-term survival to open surgery in bladder cancer. 

Researchers published a study in June 2025 in the issue of International Journal of Urology to compare perioperative, oncological, and functional outcomes of open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) with Studer urinary diversion in patients with bladder cancer.  

They assessed 454 patients who underwent open (n=242) or robotic intracorporeal neobladder (RIN) (n=212) between January 2009 and January 2020. Baseline characteristics, perioperative variables, functional outcomes, cancer-specific survival (CSS), and overall survival (OS) were documented. 

The results showed that among 454 patients (242 open, 212 robotic) followed for 120 months, the RIN group had lower blood loss (P< 0.001), more unilateral nerve sparing (P= 0.008), and higher lymph node yield (P= 0.042). Fewer 30-day readmissions were observed in the RIN group (P= 0.041), while major and minor complication rates remained comparable (P= 0.56 and 0.61, respectively). Severe daytime continence was better in the RIN group (P= 0.03), with no significant difference in erectile function (P= 0.56). In T3 disease, 10-year CSS was higher in the robotic group (68.3% vs 50.5%, P= 0.04), and OS at 10 years was 66.5% for robotic and 61.6% for open surgery (P= 0.08). 

Investigators concluded that RIN led to reduced blood loss, higher lymph node yield, fewer hospital readmissions, shorter stays, and better severe daytime continence compared to the open approach. 

Source: onlinelibrary.wiley.com/doi/10.1111/iju.70139