Open-Assisted Laparoscopic Radical Cystectomy Using an Ileal Neobladder with Intracorporeal Urethra-Neobladder Anastomosis: Technique and Early Experiences

Premsant Sangkum MD*, Suthep Patcharatrakul MD*, Wisoot Khongchareonsombat MD*

Affiliation : * Division of Urology, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Objective : Laparoscopic radical cystectomy is now widely performed in cases of muscle-invasive bladder cancer. The present study experience with laparoscopic radical cystectomy using an ileal neobladder in which urethra-neobladder anastomosis was successfully performed intracorporeally. Material and Method: Between March and November 2009, five patients underwent laparoscopic radical cystectomy using an ileal neobladder with urethra-neobladder anastomosis. Preoperative characteristics, operative data, and results were analyzed.
Results : The operation was successful for all patients. The mean operative time was 6 hours and 30 minutes. Mean estimated blood loss was 560 ml. No intraoperative complications occurred. Mean hospital stay was 19.6 days. Mean Foley catheter indwelled time was 18 days. Return of bowel function took 4.8 days. Mean time to remove silastic drain was 14.2 days. After Foley catheter removal, all patients spontaneously voided without difficulty.
Conclusion : Laparoscopic radical cystectomy of ileal neobladders using intracorporeal urethra-neobladder anastomosis is technically feasible. This technique takes advantage of laparoscopic surgery, good visualization, additional stitches, and more secure anastomosis.

Keywords : Radical cystectomy, Intracorporeal urethra-neobladder anastomosis, Laparoscopic

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