Laparoscopic Radical Cystectomy in Male Patients and Urinary Diversion

Abstract

Radical cystectomy and pelvic lymph node dissection are the standard therapy for patients with muscle-invasive bladder cancer. Parra reported Laparoscopic simple cystectomy firstly in 1992 [1]. Sanchez et al. performed the first laparoscopic radical cystectomy (LRC) in 1995, with in vitro ileal conduit [2]. Emerging laparoscopic devices and instruments, such as Ligasure vascular closure system and plasma cutting system, increased the feasibility of laparoscopic radical cystectomy. The challenging part of LRC is urinary diversion, such as orthotopic sigmoid neobladder, rectum pouch, ileal conduit, orthotopic ileal neobladder and etc. In 1995, Puppo et al. described five cases of radical cystectomy through combined transvaginal and laparoscopic approach, with ileal conduit was conducted through a minilaparotomy at the stoma site [3]. Gill et al. reported LRC with intracorporeal ileal conduit urinary diversion, later in 2002 Gill et al. performed LRC with intracorporeal continent orthotopic neobladder [4, 5]. Turk et al. reported on a series of laparoscopic radical cystectomy with controlled rectosigmoid pouch (Mainz pouch II) in five patients in 2001 [6]. Since 2004, there had been many reports regarding urinary diversion performed through a small abdominal incision to complete the ileal conduit or orthotopic continent neobladder reconstruction. Local case reports of intracorporeal laparoscopic urinary diversion were reported subsequent.