Catheterizable channel creation is indicated in a small subgroup of neurogenic patients, mostly when  the urethra cannot be used for self-catheterization. Traditionally, it is performed by the open approach.
The objective of this study was to compare the results of the robotic and  open approaches for the creation of a catheterizable channel.

A retrospective single center study was conducted including all patients who underwent a catheterizabel channel creation between 2010 and 2021. The urinary diversion was done extracorporeally with an anti-reflux mechanism according to Leadbetter Politano or Lich-Gregoire technique for the open approach cases, and intracorporeally with the Lich-Gregoire technique for the robotic approach cases, with an attachement of the bladder to the abdominal wall if the robotic technique was chosen. The functional outcomes of the procedure and the occurrence of early (< 90 days) or late complication were compared according to the approach used.

Thirty-two patients underwent catheterizable channel creation over the study period and were included: 11 in the robotic group, and 21 in the open group. Augmentation cystoplasty enterocystoplasty was performed concomitantly for 10 patients in the open group (52.4%) vs. 2 patients in the robotic group (18.2%). The perioperative outcomes were similar (see Table).  The complication rate did not differ significantly between the two groups (63.6% vs. 38.1%; p=0.26). Fifteen patients presented complications, 5 of them a major complication (one patient operated by robotic way presented a radiologically drained abscess and one patient a bad placement of the catheter operated during its placement, two patients operated by open way presented an ileal occlusion requiring a re-intervention and one patient an evisceration at day 5).
After a median follow-up of 11 and 49 months in the robotic and open groups, all patients were using their cystostomy, except for 2 patients who finally benefited from a cystectomy and non-continent ileal conduit. Thirteen patients required reoperation on catheterizable channel: 4 robotic and 9 open (36.4% vs. 42.9%; p=0.99). The rates of stomal incontinence and stenosis did not differ significantly between the two groups.

Robotic Catheterizable channel creation with intracorporeal diversion appears feasible in neurological patients with outcomes comparable to the open approach even during the learning curve.
Patients do not have more conduit stricture or leakage, and the robotic approach even may allow better conduit placement, and more bladder attachment than with the open approach. However, it does not appear to provide better functional results on the conduit.

Robotic cahteterizable channel creation seems perfectly feasible.