Diverticulectomía laparoscópica: técnica sistematizada

Abstract

ObjectivesTo present an original technique for laparoscopic vesical diverticulectomy without the need for dissecting the diverticular wall, thereby making the procedure safe and significantly simpler. Material and methodsFour patients were operated on between September 2014 and April 2016. The diagnosis was made by ultrasonography in all cases, and the study included blood and urine analyses with urine cultures, urine cytology, contrast-enhanced CT scans, prostate symptom questionnaire (International Prostate Symptom Score), flowmetry and cystoscopy. One case required transurethral prostate resection in a first time. ResultsThe mean age of the patients was 64 years (range: 56-71). The mean diverticulum size was 4cm (range: 3-6). The location was retrotrigonal in all cases, on the left side in 2 cases, right retromeatic in 1 case and near the midline in 1 case. The mean surgical time was 146min (range, 120-180), shortening for each new case. There were no significant bleeding, complications or conversion to open surgery in any of the cases. The postoperative period had no incidences. The hospital stay was 3 days in 3 cases and 48h in the other case (mean, 3.5 days). The catheter was withdrawn in the outpatient clinic at 14 days. ConclusionsThe initial experience with the technique described above shows it to be safe and reproducible, with results similar to other current laparoscopic techniques. Avoiding the dissection of the diverticular wall significantly reduces the technical difficulty of the procedure.