Robot-assisted laparoscopic diverticulectomy: our first experience
Bladder diverticulum may be congenital or acquired. In the second case diverticulum often develop on the background of infravesical obstruction. Diverticulum are protrusions of the bladder wall through a defect in its wall. Knowing that morphologically diverticulum wall is represented by muscle fibers, full emptying of the diverticulum does not usually happen. This fact leads to the constant presence of residual urine in the cavity of the diverticulum and, as a consequence to the possibility of forming stones. The clinical course of urinary bladder diverticulum are usually asymptomatic, which is manifested in their late detection. Diagnosis is based on the patient's complaints, as well as the instrumental (cystoscopy), ultrasound and X-ray, such as magnetic resonance and computed tomography and urography. The prognosis is usually favorable, however, a high risk of malignancy of diverticulum due to late diagnosis is a serious problem in oncourology. Currently, surgical treatment of urinary bladder diverticulum (diverticulectomy) includes both open and laparoscopic resection of the bladder. Tactics of treatment of acquired diverticulum must include measures aimed at addressing the causes of infravesical obstruction. Progressive development of medical technology has led to significant improvements in endoscopic treatments, including the use of robot-assisted system daVinci. In this article, we describe our own experience of robot-assisted laparoscopic diverticulectomy.