To explore the urinary control and oncological prognosis of patients with a modified Robotic intracorporeal orthotopic ileal neobladder.

A group of 10 consecutive patients underwent robot-assisted radical cystectomy and orthotopic ileal neobladder surgery from May 2017 to June 2019, including 9 males and 1 female, average age was (63±11) years, 5 cases with very high risk non-muscle invasive bladder cancer (NMIBC), 5 cases with muscle invasive bladder cancer (MIBC). The postoperative follow-up time was 12-37 months. Record the video of the operation, complications within 90 days after the operation, the patient's urinary control recovery during the follow-up period, renal function, changes in the imaging structure of the upper urinary tract, and oncology prognosis.

All the 10 patients were completed successfully the robot assisted radical cystectomy and intracorporeal orthotopic ileal neobladder, the operation time was (584±56) min, the blood loss was (655±275) ml, and the postoperative feeding time was 1-3 days; 1 patient underwent incisional hernia repair 6 months after operation, and the rest had no grade III or above complications. Some patients underwent urodynamic examination within 6-12 months after surgery, the maximum urine flow rate and average urine flow rate at the last follow-up were (6.3±4.5) ml/s and 1.80(0.30) ml/s, respectively. The postoperative neobladder filling urine volume and residual urine volume were (525±273) ml and 161(227) ml respectively. There were 9 cases (90%) of complete urinary control during the day and 8 cases (80%) of night urinary control. During the follow-up, 4 sides of renal pelvis were slightly dilated, and the monitoring sub-renal eGFR was normal. One patient developed lung metastasis 18 months after surgery, while the remaining patients did not find local recurrence or metastasis.

Our "Teapot type" ileal orthotopic neobladder is a modified intracorporeal orthotopic ileal neobladder on the basis of Student type and VIP type ileal neobladder. The function of new bladder after operation is good, which can effectively protect the structure of upper urinary tract and restore urination function.