Laparoscopic Cystectomy and Ileal Conduit: Case Report

Badajoz, Eduardo Sánchez de; Perales, J; Rosado, Andrea; Cruz, J M Gutiérrez de la; Garrido, Adolfo Jiménez

doi:10.1089/end.1995.9.59

Cited by 147 publications

(71 citation statements)

References 2 publications

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“…Three patients with stage T3aN0M0, T3aN1M0 and T3bN1M0 were receiving adjuvant chemotherapy. Mean follow up was 6.1 months (range [4][5][6][7][8][9][10][11][12][13][14] and all patients have normal renal function. No metastases have been detected and all are alive and free of disease.…”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic radical cystectomy with extracorporeal urinary diversion: Preliminary experience

et al. 2005

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Aim : We present our experience with the first eight patients who underwent laparoscopic radical cystectomy with bilateral pelvic lymphadenectomy and extracorporeal urinary diversion. Patients, operative data and the surgical techniques are presented. Methods : Between June 2003 and April 2004, seven men and one woman with organ-confined muscle-invasive transitional cell carcinoma of the bladder underwent laparoscopic radical cystectomy with urinary diversion. The age range was 41-73 years. Laparoscopic radical cystectomy and bilateral pelvic lymphadenectomy were performed using five ports by a transperitoneal approach. An ileal conduit diversion or ileal W-neobladder was constructed through the site of specimen retrieval.Results : We performed eight radical cystectomies with ileal conduits (six cases) or orthotopic ileal W-neobladders (two cases). Conversion to open surgery was necessary in one due to technical difficulty in urethroneobladder anastomosis. Mean operating time was 560 min (range 455-680).Mean estimated blood loss was 675 mL (range 400-1050). Two of the eight patients needed blood transfusion (800 mL each). Mean days to oral intake and ambulation was 4.4 (range 2-6) and 4.1 (range 3-5), respectively. Mean hospital stay was 12.8 days (range 7-28). Mean follow up was 6.1 months (range 4-14). Histopathological examination of the specimens revealed stage T2N0M0 in five cases, T3aN0M0 in one, T3aN1M0 in one and T3bN1M0 in one. No metastases have been detected and all are alive and free of disease. Conclusion : Laparoscopic radical cystectomy is feasible, although difficult and technically demanding, and our results are promising. With more experience and improvement of the surgical technique, laparoscopic radical cystectomy with urinary diversion may become an alternative surgical method for treating the selected patients with localized muscle invasive bladder cancer.

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Section: Resultsmentioning

confidence: 99%

“…in 1993. 12 Since then, LRC have been confined to a few centers in the world because it is a technically demanding procedure. The pelvic cavity is limited and there are complex vascular structures surrounding the bladder.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical cystectomy with extracorporeal urinary diversion: Preliminary experience

et al. 2005

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“…The creation of the ileal loop and ureteral re-implantation through an extended 3 cm port site incision has inherent problems such as tissue orientation that could potentially lead to positional distortion. Moreover, it may be difficult or even impossible to extract the ileum and the ureters to the skin level in obese patients (12,13).…”

Section: Commentsmentioning

confidence: 99%

Stapleless laparoscopic assisted radical cystectomy with ileal neobladder in a male and with ileal loop in a female: initial report from Brazil

et al. 2005

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Introduction: Here, we report our initial experience with laparoscopic assisted radical cystectomy without the use of surgical staples.Cases Report: A 70 year old male and a 55 year old female were diagnosed to have T2G3 transitional cell carcinoma of the bladder with negative metastatic work-out. Both patients were scheduled and agreed to a laparoscopic assisted radical cystectomy. In both cases, urinary diversion (orthotopic ileal Studer neobladder in the male and ileal conduit in the female) was performed extracorporeally following radical cystectomy. In both cases control of the bladder vascular pediclewas accomplished with a combination of metallic and hem-o-lock clips. The total surgical time was 6.5 hours in both cases. Estimated intra-operative blood loss was 500 cc and 350 cc respectively, however both patients required postoperative blood transfusions. No intraoperative complications occurred. In both cases, pathology revealed negative surgical margins.Conclusions: Extracorporeal creation of urinary diversion decrease the overall operative time. Laparoscopic pelvic lymphadenectomy can be performed following the extended template. The use of surgical clips instead of vascular Endo-GIA titanium staples to control the bladder vascular pedicles is feasible and safe in selected patients, thus reducing intraoperative surgical costs. Considerable experience with laparoscopic radical prostatectomy is necessary before one attempts laparoscopic radical cystectomy.

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“…In another case, Sanchez de Badajoz et al [50] reported the ®rst laparoscopic radical cystectomy with ileal conduit diversion in a patient with invasive bladder cancer. No data were available from this report on the length of hospital stay, operating time or complications after surgery.…”

Section: Laparoscopic Radical Cystectomymentioning

confidence: 99%