Laparoscopic Vesical Diverticulectomy

Abdel-Hakim, Amr M.; El-Feel, Ahmed; Abouel-Fettouh, Hazem; Saad, Ismail R.

doi:10.1089/end.2006.0140

Cited by 36 publications

(15 citation statements)

References 15 publications

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“…Consequently, it remains essential that obstruction is relieved either before, concomitantly or after the management of the diverticulum. Concerns were raised for the concurrent management of these 2 entities, largely based on the potential necessity of bladder irrigation and possible bladder distention after TUR-P, which might jeopardize bladder integrity following closure [8]. Due to hemostatic properties of potassium-titanyl-phosphate (KTP) laser, bleeding is minimal after PVP and bladder irrigation is generally avoidable.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction

et al. 2016

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Introduction: Robot-assisted bladder diverticulectomy (RABD) through a technique for easier identification of diverticulum along with concomitant management of bladder outlet obstruction (BOO) utilizing a combination of transurethral prostatectomy (TUR-P) and photoselective vaporization of prostate (PVP) is presented. Materials and Methods: Between 2008 and 2015, 9 patients underwent RABD with concurrent treatment of BOO. Diverticula were identified by a technique of catheterizing the diverticulum and the bladder simultaneously and individually. Results: Mean patient age was 62 ± 9.8 and prostate volume was 70 ± 26 ml. Mean time for endourological procedure was 77 ± 35, mean console and total operative times were 108 ± 38 and 186 ± 56 min, respectively. Mean estimated blood loss was 71 ± 37 ml. All diverticula were excised and BOO treated successfully. Bladder irrigation was not necessary in any patient. Mean hospitalization and catheter removal time was 5 ± 3 and 8 ± 3 days, respectively. No complications were observed. Conclusions: BOO is the main cause of acquired bladder diverticula and is largely due to benign prostatic hyperplasia. Concomitant performance of TUR-P and PVP along with RABD is feasible and safe. Individual catheterization of the diverticulum and bladder facilitates the identification of diverticulum even in the presence of multiple diverticula.

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Section: Discussionmentioning

confidence: 99%

Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction

et al. 2016

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“…Moreover, the need for continuous irrigation after TURP and during the diverticulectomy may represent a difficulty, because the bladder can be inflated and deflated intraoperatively to facilitate dissection. 6,17,18 The performance of PVP minimizes the need for irrigation intraoperatively (diverticulectomy) and postoperatively, rendering the sequential management of benign prostatic hyperplasia and bladder diverticulum feasible and safe. 20 LESS has been introduced as a further development of minimally invasive surgery and laparoscopy.…”

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confidence: 99%

“…Complications were not observed while blood loss was similar to that of the laparoscopic literature. [1][2][3][4][5][6]17,18,20,21 Conclusion LESS bladder diverticulectomy proved to be feasible with comparable postoperative outcome to that of the laparoscopic procedure. The use of prebent instruments improved intraoperative ergonomics.…”

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confidence: 99%

Laparoendoscopic Single-Site Bladder Diverticulectomy: Technique and Initial Experience

Stolzenburg

Kallidonis

et al. 2011

Journal of Endourology

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“…As a result, different methods such as intraoperative cystoscopy have been introduced to overcome identification challenges. As a useful technique, Abdel-Hakim et al [14] reported that masses could be located by inflating and deflating the bladder with air during robot-assisted LPC. The use of intraoperative real-time transrectal ultrasound guidance was also reported to be helpful in patients whose tumors were lodged within a para-ureteral diverticulum [4].…”

Section: Discussionmentioning

confidence: 99%

Use of Cystoscopic Tattooing in Laparoscopic Partial Cystectomy

et al. 2012

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PurposeDuring laparoscopic partial cystectomy (LPC), lesion identification is essential to help to determine the appropriate bladder incisions required to maintain adequate resection margins. The inability to use tactile senses makes it difficult for surgeons to locate lesions during laparoscopic surgery. Endoscopic India ink marking techniques are often used in laparoscopic gastroenterological surgery. We present our experience with performing LPC with India ink during the surgical resection of various bladder lesions.Materials and MethodsLPC with cystoscopic fine needle tattooing was performed on 10 patients at our institute. Tattooing was performed at 1- to 2-cm intervals approximately 1 cm away from the outer margin of the lesion with enough depth (the deep muscle layer) under cystoscopic guidance. LPC was performed by the transperitoneal approach. The clinical courses and pathologic results were analyzed.ResultsAll LPC with cystoscopic tattooing cases were performed successfully. The mean patient age was 39.1 years. The mean operative time was 130.5 minutes, and the mean estimated blood loss was 93 ml. The mean hospital stay was 13.1 days, and the mean duration of indwelling Foley catheterization was 10.7 days. There were no significant intraoperative or postoperative complications except 1 case of delayed urinary leak and 1 case of delayed wound healing. The pathological diagnosis included 1 urachal cancer, 1 urachal remnant, 4 urachal cysts, 2 pheochromocytomas, and 2 inflammatory masses. All specimens showed adequate surgical margins.ConclusionsCystoscopic tattooing in LPC is a simple and effective technique to assist in locating pathological bladder lesions intraoperatively. This technique can help to determine appropriate resection margins during LPC without incurring additional complicated procedures.

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Laparoscopic Vesical Diverticulectomy

Abstract: Laparoscopic diverticulectomy is technically feasible and safe and may represent an alternative to the standard open procedure.

Cited by 36 publications

References 15 publications

Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction

Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction

Laparoendoscopic Single-Site Bladder Diverticulectomy: Technique and Initial Experience

Use of Cystoscopic Tattooing in Laparoscopic Partial Cystectomy

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