Surgical video of robot-assisted totally intracorporeal modified ileal conduit urinary diversion for bladder cancer

Title: Surgical video of robot-assisted totally intracorporeal modified ileal conduit urinary diversion for bladder cancerDescription:This video demonstrates the key surgical steps of a robot-assisted, totally intracorporeal modified ileal conduit procedure for urinary diversion following radical cystectomy in a patient with bladder cancer. The procedure was performed using the KangDuo surgical robot system (SR2000).The main technical innovation shown in this video includes: routing the isolated ileal segment anterior to the sigmoid colon to the left side of the abdominal cavity, followed by an end-to-end ureteroileal anastomosis with the left ureter, and an end-to-side anastomosis with the right ureter.

This modified antecolic approach avoids extensive mobilization of the left ureter and reduces the risk of ureteral ischemia, angulation, and mesenteric torsion compared to traditional retrocolic techniques.The video covers the following sequential steps:Mobilization of the left ureter through a mesocolonic window.Mobilization of the right ureter.Isolation of a 20 cm ileal segment using an intracorporeal linear stapler.Restoration of bowel continuity and closure of the mesenteric defect.Bringing the ileal conduit anterior to the colon to the left abdomen.End-to-end left ureteroileal anastomosis using 4-0 V-Loc barbed suture.End-to-side right ureteroileal anastomosis.Suture closure of the space between the ileal conduit and the bowel.Creation of the ileal stoma.This video accompanies the research article entitled "Robotic-assisted intracorporeal radical cystectomy with modified ileal conduit reduces ureteroileal anastomotic stenosis risk: a comparative study with laparoscopic surgery" published in Annals of Medicine.