Laparoscopic Radical Cystectomy with Total Intracorporeal Ileal Neobladder: First Case Report in Thailand
Tanet Thaidumrong MD*
Affiliation : * Division of Urology, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background and
Objective : Radical cystectomy (RC) remains the gold standard for muscle-invasive, organ-confined urothelial
carcinoma (UC) of the bladder. Recently, laparoscopic surgery has been used increasingly by urologists as a minimally
invasive procedure to treat neoplasms of the pelvic organs. The present study aimed to report technical aspects of the
experience of treating Thailand’s first case of RC with bilateral pelvic lymphadenectomy and ileal neobladder under the totally
intracorporeal laparoscopic technique.
Case Report : A 67-year-old Thai male patient presented with intermediate-grade muscle- invasive UC of the bladder with
negative metastatic workout. Laparoscopic radical cystectomy and pelvic lymphadenectomy were performed using 5 abdominal
ports. Hemostasis was performed with bipolar forceps and vascular clips. The authors performed U-shape ileal neobladder
and anastomosis using the completely intracorporeal laparoscopic technique. The operative time was 10 hours, the estimated
blood loss was 1,000 ml, and there were no serious complications. The ureteric stents were removed after the 7th day, the tube
drain was removed after the 10th day, and the Foley catheter was removed after the 21th day. The post-operative pathologic
report indicated intermediate-grade muscle-invasive UC and free resection margin.
Conclusion : The authors initial experience in Laparoscopic Radical cystectomy with totally intracorporeal ileal neobladder
demonstrated that it was a feasible treatment modality. However, more cases are required in the future to confirm its efficacy
and improve laparoscopic technical performance in the treatment of organ-confined UC.
Keywords : Laparoscopic radical cystectomy, Totally intracorporal ileal neobladder, First case report in Thailand
