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Robotic surgery has the potential to radically change and strengthen cancer services, enabling patients access to the benefits of a minimally invasive approach, with a shortened learning curve [1]. There is increasing interest in both standard robotic assisted radical cystectomy (RARC) and totally intracorporeal urinary diversion as a realistic 'gold standard' alternative to open radical cystectomy (see figure 1). Robotics requires investment of time and money, and is currently perceived to be more expensive, at least in the peri-operative period. However, there is increasing evidence that robotics is most beneficial in complex surgery and can contribute to reduced complication rates in surgery such as RARC [2]. In this article we discuss various areas of service development in robotics utilizing the example of RARC surgery, which we postulate will increase the likelihood of delivering a successful service that is both advantageous to patients and cost efficient. The acronym for the headings of these different elements is 'FORTE'.

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Publisher

BJU Int.

Publication Date

29/10/2013