{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:50:02Z","timestamp":1792158602759,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":236,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the technical feasibility, perioperative safety, and short\u2010term reconstructive outcomes of a step\u2010specific reconstructive strategy during robot\u2010assisted radical cystectomy (RARC) using the da Vinci SP system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 17 consecutive patients who underwent single\u2010port\n                      <jats:styled-content style=\"fixed-case\">RARC<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">SP<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">RARC<\/jats:styled-content>\n                      ) with ileal conduit diversion. Extracorporeal bowel isolation and ileoileal anastomosis were performed in all patients. After confirmation of negative ureteral margins and adequate perfusion using indocyanine green fluorescence imaging, extracorporeal ureteroileal anastomosis was performed when tension\u2010free anastomosis was feasible; otherwise, the robot was re\u2010docked and intracorporeal ureteroileal anastomosis was selectively performed. Robot\u2010assisted retroperitonealization of the ureteroileal anastomosis was attempted in all patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median operative time was 405 min and median estimated blood loss was 345\n                      <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\n                      . Bilateral extracorporeal ureteroileal anastomosis was completed in nine patients, whereas selective intracorporeal anastomosis of one or both ureters was performed in eight. In five of these eight patients, additional ureteral resection based on frozen\u2010section or perfusion assessment resulted in insufficient length for tension\u2010free extracorporeal anastomosis. Retroperitonealization was completed in 14 patients. No conversion to open surgery occurred. Clavien\u2013Dindo grade\n                      <jats:styled-content style=\"fixed-case\">\u2265\u2009II<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">\u2265\u2009III<\/jats:styled-content>\n                      complications occurred in seven and three patients, respectively. At the most recent imaging follow\u2010up, no renal unit had Society for Fetal Urology grade \u2265\u20093 hydronephrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This step\u2010specific strategy was technically feasible, preserving extracorporeal bowel reconstruction as the standard approach while allowing selective intracorporeal ureteroileal anastomosis when required. It prioritized negative margins, ureteral perfusion, anastomotic tension, and operative safety over rigid adherence to a single reconstructive method.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70372","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T01:16:40Z","timestamp":1787707000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Initial Experience With a Step\u2010Specific Reconstructive Strategy During Robot\u2010Assisted Radical Cystectomy Using the da Vinci\n                    <scp>SP<\/scp>\n                    System"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8613-9068","authenticated-orcid":false,"given":"Yuki","family":"Kamiyama","sequence":"first","affiliation":[{"name":"Department of Urology Kyoto City Hospital  Kyoto 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