Minimally Invasive Laparoscopic Neobladder

No AccessJournal of UrologyCLINICAL UROLOGY: UROLOGISTS AT WORK1 Sep 2002Minimally Invasive Laparoscopic Neobladder F. Gaboardi, A. Simonato, S. Galli, A. Lissiani, A. Gregori, and A. Bozzola F. GaboardiF. Gaboardi , A. SimonatoA. Simonato , S. GalliS. Galli , A. LissianiA. Lissiani , A. GregoriA. Gregori , and A. BozzolaA. Bozzola View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64579-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To our knowledge orthotopic reconstruction after laparoscopic radical cystectomy has not been described in the human. After anatomical and surgical studies on cadavers we developed an original technique and performed the first laparoscopic radical cystectomy with pelvic lymphadenectomy and ileal orthotopic neobladder reconstruction in a patient. Materials and Methods: Our technique has 3 steps, namely laparoscopic pelvic clearance, external reconstruction and laparoscopic reconstruction. After cystoprostatectomy and lymphadenectomy were completed via laparoscopy we removed the surgical specimens through a 5 cm. supraumbilical incision. Through the same incision an ileal loop was extracted from the abdominal cavity, isolated, detubularized and partially reconfigured. Intestinal continuity was restored extracorporeally. All intestinal loops were inserted back into the abdomen and pneumoperitoneum was started again. The ureteroileal (nipple valve) and urethroileal anastomoses were formed via laparoscopy and the neobladder was then completed with an intracorporeal running suture. Results: Operative time was 450 minutes and blood loss was 350 ml. Postoperatively pain was minimal. The patient was ambulatory, regained bowel activity on postoperative day 2 and began food intake 2 days later. He was discharged home on postoperative day 7 with an indwelling catheter, which was removed after 7 days. Histopathological examination showed organ confined bladder cancer without margin invasion. Conclusions: To our knowledge we report the first case of laparoscopic radical cystectomy with ileal orthotopic reconstruction. This original technique combines the advantages of minimally invasive laparoscopy with the speed and safety of open surgery. References 1 : Laparoscopic radical prostatectomy: the Montsouris experience. J Urol2000; 163: 1643. Link, Google Scholar 2 : Future developments perspectives in laparoscopy. Eur Urol2001; 40: 84. Crossref, Medline, Google Scholar 3 : Editorial: new laparoscopic approaches. J Urol2001; 165: 1967. Link, Google Scholar 4 : Laparoscopically assisted transvaginal radical cystectomy. Eur Urol1995; 27: 80. Crossref, Medline, Google Scholar 5 : Laparoscopic radical cystoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases. Urology2000; 56: 26. Crossref, Medline, Google Scholar 6 : Laparoscopic radical cystectomy with continent urinary diversion (rectal sigmoid pouch) performed completely intracorporeally: the initial 5 cases. J Urol2001; 165: 1863. Link, Google Scholar 7 : Laparoscopic assisted cystectomy lymphadenectomy for bladder cancer: initial experience. World J Surg1999; 23: 608. Crossref, Medline, Google Scholar 8 : Laparoscopic orthotopic ileal neobladder. J Endourol2001; 15: 131. Crossref, Medline, Google Scholar 9 : The everting suture: a new technical aid for ureteral nipple construction. J Urol1996; 155: 1372. Link, Google Scholar 10 : Lower urinary tract reconstruction following cystectomy: experience results in 126 patients using the Kock ileal reservoir with bilateral ureteroileal urethrostomy. J Urol1991; 146: 756. Link, Google Scholar 11 : The ileal neobladder: complications functional results in 363 patients after 11 years of followup. J Urol1999; 161: 422. Link, Google Scholar 12 : Three years' experience with an ileal low pressure bladder substitute. Br J Urol1989; 63: 43. Crossref, Medline, Google Scholar 13 : Laparoscopic cystectomy ileal conduit: case report. Br J Urol1995; 9: 59. Google Scholar 14 : Laparoscopic colorectal cancer surgery. Am J Surg2000; 179: 500. Crossref, Medline, Google Scholar 15 : Laparoscopic surgery surgical infection. Br J Surg2000; 87: 536. Crossref, Medline, Google Scholar 16 : Laparoscopy in children and adults. In: Campbell's Urology. Edited by . Philadelphia: W. B. Saunders Co.1998: 2875. chapt. 5. Google Scholar From the Department of Urology, "Luigi Sacco" Hospital, Milan, Italy© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Bianchi R, Mistretta F, Musi G, Luzzago S, Morelli M, Lorusso V, Catellani M, Di Trapani E, Cozzi G, Ferro M, Bottero D, Matei D and de Cobelli O (2021) Robot-Assisted Intracorporeal Orthotopic Ileal Neobladder: Description of the "Shell" TechniqueJournal of Clinical Medicine, 10.3390/jcm10163601, VOL. 10, NO. 16, (3601) Rassweiler J, Gözen A, Fiedler M and Klein J (2018) Laparoscopic Radical Hysterectomy (LRH) with Anterior and Posterior Exenteration: Urological Perspectives Hysterectomy, 10.1007/978-3-319-22497-8_46, (661-673), . Rassweiler J, Gözen A, Fiedler M and Klein J (2017) Tips for Ideal Urinary Diversion Practical Tips in Urology, 10.1007/978-1-4471-4348-2_69, (695-711), . Gaboardi F, Pini G and Suardi N (2017) Robotic Radical Cystectomy and Urinary Diversions: Step-by-Step Technique Practical Tips in Urology, 10.1007/978-1-4471-4348-2_68, (683-693), . Azzouni F, Din R, Rehman S, Khan A, Shi Y, Stegemann A, Sharif M, Wilding G and Guru K (2013) The First 100 Consecutive, Robot-assisted, Intracorporeal Ileal Conduits: Evolution of Technique and 90-day OutcomesEuropean Urology, 10.1016/j.eururo.2012.11.055, VOL. 63, NO. 4, (637-643), Online publication date: 1-Apr-2013. Akin Y, Celik O, Ates M, Nuhoglu B and Erdogru T (2013) Evaluation of Open and Laparoscopic Radical Cystoprostatectomy Combined with Orthotopic Neobladder: A Single-Surgeon ExperienceUrologia Internationalis, 10.1159/000346755, VOL. 90, NO. 3, (348-353), . Guillotreau J and Gamé X (2012) Cistoprostatectomías totales laparoscópica y robótica para el cáncer de vejigaEMC - Urología, 10.1016/S1761-3310(12)63538-5, VOL. 44, NO. 4, (1-11), Online publication date: 1-Dec-2012. Rassweiler J, Hruza M, Frede T and Micali S (2012) Current State of Laparoscopic and Robotic Surgery Simulation Training in Laparoscopy and Robotic Surgery, 10.1007/978-1-4471-2930-1_3, (15-29), . Gillion N, Xylinas E, Durand X, Ploussard G, Vordos D, Allory Y, Hoznek A, de la Taille A, Abbou C and Salomon L (2011) Mid-term oncological control after laparoscopic radical cystectomy in men: a single-centre experienceBJU International, 10.1111/j.1464-410X.2010.10054.x, VOL. 108, NO. 7, (1180-1184), Online publication date: 1-Oct-2011. Zhou N, Chen J, Liu Q, Zhang X, Wang Z, Ren S and Chen X (2011) Outcomes of pancreatoduodenectomy with robotic surgery versus open surgeryThe International Journal of Medical Robotics and Computer Assisted Surgery, 10.1002/rcs.380, VOL. 7, NO. 2, (131-137), Online publication date: 1-Jun-2011. Canes D and Tuerk I (2010) Laparoscopic Cystectomy and Urinary Diversion Essential Urologic Laparoscopy, 10.1007/978-1-60327-820-1_16, (277-289), . Simonato A and Gregori A (2009) Re: Georges-Pascal Haber, Sebastien Crouzet, Inderbir S. Gill. Laparoscopic and Robotic-Assisted Radical Cystectomy for Bladder Cancer: A Critical Analysis. Eur Urol 2008;54:54–64European Urology, 10.1016/j.eururo.2008.07.070, VOL. 55, NO. 1, (e13-e14), Online publication date: 1-Jan-2009. Vaessen C Laparoscopic Cystectomy and Laparoscopically Assisted Orthotopic Neobladder Operative Atlas of Laparoscopic Reconstructive Urology, 10.1007/978-1-84800-151-0_34, (495-500) Lesur G and Rouprêt M (2008) Place de la cystectomie radicale par voie laparoscopique dans le traitement des carcinomes urothéliaux infiltrants de vessieProgrès en Urologie, 10.1016/j.purol.2007.08.001, VOL. 18, NO. 3, (145-151), Online publication date: 1-Mar-2008. Wagner A, Müntener M, Makarov D, Nielsen M, Scorpio D and Kavoussi L (2008) Total Laparoscopic Creation of a Novel Stapled Orthotopic Neobladder in the Porcine ModelJournal of Endourology, 10.1089/end.2007.9855, VOL. 22, NO. 1, (151-156), Online publication date: 1-Jan-2008. Wagner A and Pavlovich C (2008) Cistectomía radical y derivación urinaria laparoscópicas Atlas de cirugía urológica laparoscópica, 10.1016/B978-84-458-1869-5.50025-5, (282-296), . Porpiglia F, Renard J, Billia M, Scoffone C, Cracco C, Terrone C and Scarpa R (2007) Open versus Laparoscopy-Assisted Radical Cystectomy: Results of a Prospective StudyJournal of Endourology, 10.1089/end.2006.0224, VOL. 21, NO. 3, (325-329), Online publication date: 1-Mar-2007. Guru K, Kim H, Piacente P and Mohler J (2007) Robot-Assisted Radical Cystectomy and Pelvic Lymph Node Dissection: Initial Experience at Roswell Park Cancer InstituteUrology, 10.1016/j.urology.2006.10.037, VOL. 69, NO. 3, (469-474), Online publication date: 1-Mar-2007. Gamé X, Mallet R, Guillotreau J, Berrogain N, Mouzin M, Vaessen C, Sarramon J, Malavaud B and Rischmann P (2007) Uterus, Fallopian Tube, Ovary and Vagina-Sparing Laparoscopic Cystectomy: Technical Description and ResultsEuropean Urology, 10.1016/j.eururo.2006.06.052, VOL. 51, NO. 2, (441-446), Online publication date: 1-Feb-2007. XIA G, DING Q, XU K and ZHANG Y (2007) Laparoscopic radical cystectomy with ileal neobladder and rectum pouch: the initial experience of 28 cases in ChinaChinese Medical Journal, 10.1097/00029330-200701020-00011, VOL. 120, NO. 2, (132-135), Online publication date: 1-Jan-2007. Wagner A and Pavlovich C (2007) Laparoscopic Radical Cystectomy and Urinary Diversion Atlas of Laparoscopic Urologic Surgery, 10.1016/B978-1-4160-2580-1.50030-6, (282-296), . Hemal A and Menon M Robot-Assisted Radical Cystectomy and Urinary Diversion Robotic Urologic Surgery, 10.1007/978-1-84628-704-6_22, (161-168) Castillo O, Pinto I, Rossi R and Urena R (2006) Case Report: Laparoscopy-Assisted Urinary Undiversion: Transforming an Ileal Conduit into an Orthotopic Continent NeobladderJournal of Endourology, 10.1089/end.2006.20.899, VOL. 20, NO. 11, (899-903), Online publication date: 1-Nov-2006. Miller N and Theodorescu D (2006) Status of robotic cystectomy in 2005World Journal of Urology, 10.1007/s00345-006-0066-2, VOL. 24, NO. 2, (180-187), Online publication date: 1-Jun-2006. Castillo O and Cortés O (2006) Complicaciones en cirugía laparoscópica urológicaActas Urológicas Españolas, 10.1016/S0210-4806(06)73493-3, VOL. 30, NO. 5, (541-554), Online publication date: 1-Jan-2006. Castillo O, Cabello Benavente R, Briones Mardones G and Hernández Fernández C (2006) Cistectomía Radical LaparoscópicaActas Urológicas Españolas, 10.1016/S0210-4806(06)73492-1, VOL. 30, NO. 5, (531-540), Online publication date: 1-Jan-2006. Hemal A and Menon M Robot-Assisted Radical Cystectomy and Urinary Diversion in Bladder Cancer Endourological Management of Urogenital Carcinoma, 10.1007/4-431-27786-2_8, (119-126) Vordos D, Hoznek A, Gettman M and Abbou C (2005) Laparoscopic Cystectomy – Evolution of A New TechniqueEAU Update Series, 10.1016/j.euus.2005.07.005, VOL. 3, NO. 3, (147-155), Online publication date: 1-Sep-2005. Cathelineau X, Arroyo C, Rozet F, Barret E and Vallancien G (2005) Laparoscopic Assisted Radical Cystectomy: The Montsouris Experience after 84 CasesEuropean Urology, 10.1016/j.eururo.2005.04.001, VOL. 47, NO. 6, (780-784), Online publication date: 1-Jun-2005. Simonato A, Gregori A, Lissiani A, Bozzola A, Galli S and Gaboardi F (2005) Laparoscopic Radical Cystoprostatectomy: Our Experience in A Consecutive Series of 10 Patients with a 3 Years Follow-UpEuropean Urology, 10.1016/j.eururo.2005.02.011, VOL. 47, NO. 6, (785-792), Online publication date: 1-Jun-2005. Rassweiler J, Frede T, Teber D and van Velthoven R (2009) Laparoscopic radical cystectomy with and without orthotopic bladder replacementMinimally Invasive Therapy & Allied Technologies, 10.1080/13645700510033921, VOL. 14, NO. 2, (78-95), Online publication date: 1-Apr-2005. Canes D, Triaca V and Tuerk I (2005) Laparoscopic radical cystectomy with continent urinary diversionCurrent Urology Reports, 10.1007/s11934-005-0077-3, VOL. 6, NO. 2, (109-117), Online publication date: 1-Mar-2005. Cestari A, Naspro R, Riva M, Bellinzoni P, Nava L, Rigatti P and Guazzoni G (2005) Nerve-sparing laparoscopic cystectomyCurrent Urology Reports, 10.1007/s11934-005-0075-5, VOL. 6, NO. 2, (101-105), Online publication date: 1-Mar-2005. Rackley R, Abdelmalak J, El-Azab A, Vasavada S and Gill I (2004) Laparoscopic bladder augmentation and urinary diversion Urinary Diversion, 10.1201/b14347-40, (363-375), Online publication date: 14-Dec-2004. DeGer S, Peters R, Roigas J, Wille A, Tuerk I and Loening S (2004) Laparoscopic radical cystectomy with continent urinary diversion (rectosigmoid pouch) performed completely intracorporeally: An intermediate functional and oncologic analysisUrology, 10.1016/j.urology.2004.07.004, VOL. 64, NO. 5, (935-939), Online publication date: 1-Nov-2004. Hemal A, Abol-Enein H, Tewari A, Shrivastava A, Shoma A, Ghoneim M and Menon M (2004) Robotic radical cystectomy and urinary diversion in the management of bladder cancerUrologic Clinics of North America, 10.1016/j.ucl.2004.06.009, VOL. 31, NO. 4, (719-729), Online publication date: 1-Nov-2004. TAYLOR G, DUCHENE D and KOENEMAN K (2018) HAND ASSISTED LAPAROSCOPIC CYSTECTOMY WITH MINILAPAROTOMY ILEAL CONDUIT: SERIES REPORT AND COMPARISON WITH OPEN CYSTECTOMYJournal of Urology, VOL. 172, NO. 4 Part 1, (1291-1296), Online publication date: 1-Oct-2004.BASILLOTE J, ABDELSHEHID C, AHLERING T and SHANBERG A (2018) LAPAROSCOPIC ASSISTED RADICAL CYSTECTOMY WITH ILEAL NEOBLADDER: A COMPARISON WITH THE OPEN APPROACHJournal of Urology, VOL. 172, NO. 2, (489-493), Online publication date: 1-Aug-2004. Moinzadeh A and Gill I (2004) Laparoscopic radical cystectomy with urinary diversionCurrent Opinion in Urology, 10.1097/00042307-200403000-00006, VOL. 14, NO. 2, (83-87), Online publication date: 1-Mar-2004. Menon M, Hemal A, Tewari A, Shrivastava A, Shoma A, Abol-Ein H and Ghoneim M (2004) Robot-Assisted radical cystectomy and urinary diversion in female patients: technique with preservation of the uterus and vagina1Journal of the American College of Surgeons, 10.1016/j.jamcollsurg.2003.11.010, VOL. 198, NO. 3, (386-393), Online publication date: 1-Mar-2004. Sakakibara N, Sakuta T and Katano H (2004) Laparoscopic Radical Cystectomy and Urinary Diversion New Challenges in Laparoscopic Urologic Surgery, 10.1007/978-4-431-67943-1_12, (153-162), . Hemal A, Singh I and Kumar R (2003) Laparoscopic Radical Cystectomy and Ileal Conduit Reconstruction: Preliminary ExperienceJournal of Endourology, 10.1089/089277903772036271, VOL. 17, NO. 10, (911-916), Online publication date: 1-Dec-2003. Guazzoni G, Cestari A, Colombo R, Lazzeri M, Montorsi F, Nava L, Losa A and Rigatti P (2003) Laparoscopic Nerve- and Seminal-Sparing Cystectomy with Orthotopic Ileal Neobladder: The First Three CasesEuropean Urology, 10.1016/S0302-2838(03)00363-4, VOL. 44, NO. 5, (567-572), Online publication date: 1-Nov-2003. Abrahams H, Meng M and Stoller M (2003) Simplified pure laparoscopic bowel anastomosisUrology, 10.1016/S0090-4295(03)00343-1, VOL. 62, NO. 3, (547-549), Online publication date: 1-Sep-2003. Menon M, Hemal A, Tewari A, Shrivastava A, Shoma A, El-Tabey N, Shaaban A, Abol-Enein H and Ghoneim M (2003) Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversionBJU International, 10.1046/j.1464-410X.2003.04329.x, VOL. 92, NO. 3, (232-236) Simonato A, Gregori A, Lissiani A, Bozzola A, Galli S and Gaboardi F (2003) Laparoscopic Radical Cystoprostatectomy: A Technique Illustrated Step by StepEuropean Urology, 10.1016/S0302-2838(03)00214-8, VOL. 44, NO. 1, (132-138), Online publication date: 1-Jul-2003. (2003) LiteratureWatchJournal of Endourology, 10.1089/08927790360587469, VOL. 17, NO. 2, (117-124), Online publication date: 1-Mar-2003. Simonato A, Lissiani A, Gregori A, Bozzola A, Galli S and Gaboardi F (2018) A Combined Technique for Radical Cystoprostatectomy and Orthotopic Ileal NeobladderUrologia Journal, 10.1177/039156030307001-404, VOL. 70, NO. 1-4, (22-28), Online publication date: 1-Jan-2003. (2002) Literature WatchPediatric Endosurgery & Innovative Techniques, 10.1089/109264102321111646, VOL. 6, NO. 4, (295-301), Online publication date: 1-Dec-2002. Volume 168Issue 3September 2002Page: 1080-1083 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsurinary diversioncystectomylaparoscopyminimally invasive surgerybladderMetricsAuthor Information F. Gaboardi More articles by this author A. Simonato More articles by this author S. Galli More articles by this author A. Lissiani More articles by this author A. Gregori More articles by this author A. Bozzola More articles by this author Expand All Advertisement PDF downloadLoading ...