Hello @deedubs1980 and welcome to Mayo Connect. You have a good record of beating cancer in your lifetime. So sorry that you had to have that battle at all. My husband had a neobladder surgery at Mayo Clinic in 2021. he was only offered open surgery likely because he had a previous partial cystectomy to remove the original tumor, and 29 lymph nodes removed at that time. That leaves a lot of scar tissue to deal with. Nerve sparing was never discussed. With his many complications postop and over the next 2 years, he has had a couple other surgeries done robotically. A large incisional hernia repair placing mesh across his abdomen was done robotically and the recovery was amazingly quick and less painful. If your surgeon feels that a robotic or even semi gives the same survival odds as open, then I would suggest that route for a faster recovery and less discomfort. Where are you receiving your medical care, if you don't mind sharing?