Abstract
SummaryA 4-year-old child presented with recurrence of an embryonal rhab-domyosarcoma following previous limited excision, chemotherapy and pelvic irradiation. A decision was made to excise the bladder and prostate and a preliminary staging laparoscopy was performed to exclude extra-vesical meta-stases. It was evident that excellent access to retropubic structures could be obtained endoscopically, so informed consent was obtained for a laparoscopic cysto-prostatectomy. The bladder, bladder neck and urethra were entirely mobilized laparoscopically. Total laparoscopic time was 90min and blood loss 150 ml. The need to create a permanent urinary diversion allowed us to make a 5cm Pfannensteil incision to deliver the bladder and fashion an ileal conduit through this small incision. The patient made an uneventful recovery and was discharged after 6 days. Combining laparoscopy with conventional open surgery allowed us to gain access to a difficult anatomical site. Given the right indications, laparoscopic assist...
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