This video presentation details a robot-assisted laparoscopic radical cystoprostatectomy with orthotopic ileal neobladder reconstruction using the Hautmann technique, performed with the Da Vinci Xi Surgical System in a 69 year old male diagnosed with clinical stage II (T2N0M0) muscle-invasive papillary urothelial carcinoma of the bladder.

Following thorough staging and multidisciplinary evaluation, the patient was selected for curative intent surgery with orthotopic diversion. The video highlights key procedural components, including en bloc cystoprostatectomy, and bilateral pelvic lymphadenectomy. Ileal segment isolation and detubularization are performed extracorporeally, followed by Hautmann neobladder reconstruction with intracorporeal urethro-neobladder anastomosis. Intraoperative strategies to optimize tissue handling, minimize ureteroenteric complications, and maintain adequate vascularization of the neobladder are accomplished.

The procedure was completed without intraoperative complications. Estimated blood loss was minimal, and operative time was within standard parameters. Final pathology confirmed pT2aN0 disease with negative surgical margins and adequate lymph node yield. The patient’s postoperative recovery was uneventful, with early return of bowel function and preserved continence at follow-up.

This case underscores the feasibility of robot assisted laparoscopic cystoprostatectomy with neobladder reconstruction in appropriately selected patients, reinforcing the role of minimally invasive approaches in urologic oncology practice.