# Robotic-assisted radical cystoprostatectomy and intracorporeal ileal conduit formation in a patient with prior total colectomy and J-pouch

## TL;DR

This paper describes a successful robotic surgery for bladder cancer in a patient with prior bowel surgery, highlighting new techniques to manage complex anatomy.

## Contribution

The paper presents the first reported case of robotic-assisted cystoprostatectomy in a patient with prior total colectomy and J-pouch.

## Key findings

- The surgery was completed without complications using intraoperative strategies like rectal indocyanine green and a short discard segment.
- The patient had favorable oncologic and functional outcomes postoperatively.
- The case outlines technical considerations for cystectomy in patients with prior large bowel resection.

## Abstract

We present the first reported case of robotic-assisted radical cystoprostatectomy and ileal conduit formation in a patient with prior total colectomy and J-pouch. The anatomy posed significant technical risk due to end artery pouch perfusion and changes in the posterior plane. Intraoperative strategies, including rectal indocyanine green and a short discard segment when constructing the conduit enabled successful outcomes. The procedure was completed without complication, and the patient had a favourable oncologic and functional status postoperatively. This case demonstrates the technical considerations of cystectomy in patients with previous large bowel resection and reconstruction, and the outlined strategies are relevant across multiple clinical settings.