• Muscle-invasive bladder cancer

• Patients need radical cystectomy and diversion

• Candidates for orthotopic neobladder

• Female patients with organ-preserving option

• Patients refuse ileal conduit

China Medical University Hospital's Urology Department, led by Director Chi-Ping Huang, performs intracorporeal Da Vinci radical cystectomy with orthotopic neobladder (J-pouch) reconstruction — one of few medical centers in Taiwan to complete this high-difficulty surgery. The procedure is performed entirely within the body, preserving the longest urethra, neurovascular bundle, and harvesting more lymph nodes (median 30). Innovations include double-J-tubeless urinary reconstruction, modified J-pouch to shorten operation time, and female pelvic organ preservation to reduce urinary retention. ERAS protocols are implemented; bi-weekly multidisciplinary meetings and weekly imaging discussions are held. 27 cumulative cases: 2.3-year overall survival 81.8%, Stage III 4-year survival 59.88% (national 38.67%), daytime continence 81.8%, nighttime continence 66.7%. All patients are followed by dedicated cancer case managers.

• Total intracorporeal Da Vinci surgery

• Double-J-tubeless reconstruction

• Modified J-pouch shortens operation

• Female pelvic organ preservation

• ERAS recovery protocol

• Da Vinci training system

• Cumulative 27 cases, median age 64

• Median operation time: 622 min

• Median blood loss: 100ml; 0% transfusion

• Median lymph nodes retrieved: 30

• Median LOS: 16 days

• #4 in Taiwan for Da Vinci surgery

• 2.3-yr OS 81.8%; DFS 92.6%

• Stage III 4-yr OS 59.88% (national 38.67%)

• Margin positive 0%; recurrence 11.1%

• Daytime continence 81.8%; nighttime 66.7%

• Top 5 nationally for new BCa diagnoses

• Loss-to-follow-up: 0%

• Overall complications 44.4% (EU 53.7%)

• Early complications 40.7% (Asia 57.7%)

• Clavien-Dindo ≥III 25.9%

• Transfusion rate 0% (intl 1-56%)

• Urinary retention 0% (intl 4-60%)

• Stable long-term renal function

• Overall satisfaction: 9.22/10

• Staff professionalism: 9.33

• Explanations: 9.16

• Environment and process: 9.22

• Near 100% positive feedback

• Regular patient association meetings

• 2023 publication in IJMRCAS (IF 2.5)

• 2019/21/22 TUA Annual Meeting presentations

• 2020 Da Vinci/laparoscopic surgery video contest winner

• Outperforms JAMA, Eur Urol benchmarks

• Leading blood loss, LN, continence rates

• Pioneers Central Taiwan Da Vinci

• Significantly improved post-op QoL

• Catalyzes other medical centers

• Sets benchmark for Da Vinci bladder reconstruction

• Advocates NHI coverage

• Trains next-generation Da Vinci surgeons