At UNC Urology, innovation shows up in the operating room—and in patient recovery. Urologic oncologist Mary Elizabeth Westerman, MD has introduced robotic intracorporeal urinary diversions to Chapel Hill, expanding advanced options for patients who require bladder removal (radical cystectomy).
What is an Intracorporeal Diversion?
After removal of the bladder, surgeons create a new route for urine to leave the body (a urinary diversion). Traditionally, that reconstruction is done outside the body through a larger incision (extracorporeal). With intracorporeal diversion, the entire reconstruction is performed inside the abdomen using robotic assistance—eliminating the need to exteriorize bowel or the new conduit.
Why it Matters
Early data from randomized trials (including the iROC study in JAMA) link fully robotic, intracorporeal approaches with patient-centered recovery advantages, including:
- Faster recovery and shorter hospital stays
- Fewer wound and thromboembolic complications
- Improved early quality-of-life measures
Patients undergoing robotic intracorporeal reconstruction may experience several benefits within the first 90 days compared to those who had open procedures, including better early physical function and less disability.[1] For many bladder cancer patients—often older and managing other conditions—these differences are especially meaningful in the first weeks after surgery. It’s important for each patient to speak with their doctor to determine which approach would be most helpful in their case.
At-a-Glance
- Reconstruction stays inside the body (no exteriorized bowel)
- Small incisions, precise suturing, stable visualization
- Aims for faster recovery and fewer wound-related issues
“By utilizing robotic intracorporeal urinary diversions, we aim to enhance patient recovery and improve outcomes by keeping the entire reconstruction process within the body. This approach not only reduces complications but also speeds up recovery, allowing patients to return to their daily lives more quickly and comfortably.”
Mary Beth Westerman, MD
Associate Professor of Urology
A Surgeon Focused on Outcomes
Dr. Westerman is a urologic oncologist whose practice centers on complex bladder cancer surgery and intracorporeal diversion techniques. Her research and national service emphasize enhanced recovery, quality improvement, and improving outcomes for women undergoing radical cystectomy. She serves on the AUA Practice Guidelines Committee and contributes to multi-center clinical trials and cooperative groups—bringing a rigorous, evidence-first mindset to surgical innovation at UNC.
By offering intracorporeal diversions, Dr. Westerman is expanding what’s possible for cystectomy patients at an academic medical center—aligning technical excellence with patient-centered recovery.
To Learn More
If you or a loved one are interested in learning more about these procedures or related urologic topics, you may visit our website’s Patient Care section, or meet with a provider by contacting one of our UNC Urology clinic locations.
About Our Ahead of the Curve Series
Our “Ahead of the Curve” blog series highlights the latest and most effective treatments and techniques in patient care at UNC Urology. Urology is a complex and rapidly evolving field, with new advancements and breakthroughs constantly emerging. In this series, we will explore a range of topics related to innovative approaches to providing outstanding patient care, including advanced surgical procedures, new and improved diagnostic techniques, and innovative medical therapies. Our goal is to provide you with an overview of the excellence and innovation happening right here at UNC Urology.
Citation
Catto JWF, Khetrapal P, Ricciardi F, et al. Effect of Robot-Assisted Radical Cystectomy With Intracorporeal Urinary Diversion vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients With Bladder Cancer: A Randomized Clinical Trial. JAMA. 2022;327(21):2092–2103. doi:10.1001/jama.2022.7393