Radical Cystectomy Using Endoscopic Stapling Devices: Preliminary Experience With a Simple and Reliable Technique

Abstract

We introduce a new technique to decrease operative time and blood loss during radical cystectomy. We used endoscopic stapling devices for secure hemostasis, as well as rapid division of the bladder and prostatic lateral ligaments, and the deep dorsal vein complex during radical cystectomy in 16 patients with bladder or urethral cancer compared to 11 who underwent cystectomy via a conventional method, consisting of incision and ligation with sutures. In most cases the endoscopic staplers were useful for sufficient hemostasis and rapid division of the ligaments and/or venous plexus. Mean total operative time with the stapling technique was significantly shorter than that with the standard technique (p = 0.003), and mean total blood loss was less than with the standard technique but the difference was not statistically significant. Although our study was not designed in a randomized manner, we believe that endoscopic stapling devices facilitate radical cystectomy.