# Early Experience With Robotic-Assisted Radical Cystectomy: A Six-Case Series From a UK Centre

## TL;DR

This paper reports on the early outcomes of six robotic-assisted bladder cancer surgeries in the UK, showing safe procedures with no major complications or deaths.

## Contribution

The study provides initial UK-based clinical experience with robotic-assisted radical cystectomy, contributing to its growing adoption.

## Key findings

- All six patients had successful surgeries without intraoperative transfusions or conversion to open surgery.
- Postoperative complications were minor and managed conservatively, with no 30- or 90-day mortality.
- Pathology results showed negative surgical margins in five cases and no recurrence at early follow-up.

## Abstract

Background: Robotic-assisted radical cystectomy (RARC) is increasingly adopted as a minimally invasive alternative to open radical cystectomy for muscle-invasive and high-risk non-muscle-invasive bladder cancer. This study presents early outcomes from the first six robotic cystectomies performed at a UK tertiary centre.

Methods: A retrospective review was performed of the first six patients who underwent RARC between May and July 2025. Data collected included patient demographics, operative details, complications (graded by Clavien-Dindo), pathology, and follow-up outcomes.

Results: The median age was 65.5 years (range: 54-70), with four males and two females. The median body mass index (BMI) was 29.1. The median total operative time was 466.5 minutes (range: 429-511), with estimated blood loss ranging from 200 to 900 mL. No patients required intraoperative transfusion or conversion to open surgery. Two patients developed postoperative ileus and one experienced stoma retraction; all were managed conservatively. There was no 30- or 90-day mortality. Pathology demonstrated stages ranging from Ta to T2a, with negative surgical margins in five cases, and one result awaited at the time of reporting. At an early median follow-up period, all patients were alive without evidence of recurrence.

Conclusions: RARC was safely introduced at our centre, with perioperative outcomes comparable to early series internationally. Ongoing data collection and longer follow-up are required to assess oncological durability and functional outcomes.