What steps would you take if the ileal conduit does not have enough length to reach the skin level during a robotic radical cystectomy and ileal conduit?

First, desufflate and proceed with this portion open. You may have enough length when the abdomen is totally flat (and not insufflated at all). If that doesn't work, you may cut deeper into the mesentery to let it pull up more, but watch out for the blood supply. Think about using SPY or Firefly to ...