Laparoscopic Cystoprostatectomy Research Articles

Nerve-Sparing Laparoscopic Cystoprostatectomy Based on Inferior Hypogastric Plexus Dissection: Our Initial Experience

Introduction: The aim of this study was to implement our technique for the initial dissection of the inferior hypogastric plexus and protection of the autonomic nerve supply to the corpora cavernosa in laparoscopic radical cystoprostatectomy with an orthotopic ileal neobladder and report the initial outcomes. Methods: Eleven normally potent patients with preoperative cT2N0 bladder cancer who underwent bilateral nerve-sparing laparoscopic cystoprostatectomy performed by the same surgeon were selected from May 2018 to September 2020. In this procedure, the anterior part of the inferior hypogastric plexus was dissected first between the prehypogastric nerve fascia and rectal proper fascia medial to the distal ureter. Then the Denonvilliers’ fascia and the nerves around the prostate were preserved according to current intrafascial principles. The preliminary operative, oncologic, and functional results are presented. Results: The median follow-up duration was 18 months. We observed early and late complications in 5 patients, but none exceeded grade III. Of the 11 patients, ten gained daytime continence (90.9%), and 8 (72.7%) showed nocturnal continence at the last follow-up. Regarding postoperative potency, 10 of the 11 patients (90.9%) remained potent with or without oral medications, excluding one who had partial tumescence but did not follow our recommendations regarding medication use. No local recurrence or positive surgical margins were noted. Conclusion: In addition to emphasizing our cavernosal nerve-sparing procedure, this report on the precise dissection and protection of the inferior hypogastric plexus could be of clinical significance, providing potentially ideal short-term functional results.

Transperitoneal Laparoscopic Cystoprostatectomy for Muscle Invasive Bladder Cancer: Results and Oncologic Outcomes in a Single Center in Douala Cameroon

Background and Aim: Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. Although open surgery is currently the gold standard for this procedure, it can also be done via laparoscopy. We aimed to evaluate the oncologic results and the place of laparoscopic cystectomy in the management of bladder cancer in a single urology center in Douala, Cameroon. Patients and Methods: This is a prospective, single-center study carried out from 2015 to 2019. We included 12 patients (ten men and two women) with bladder cancer who underwent total radical laparoscopic transperitoneal cystectomy with ilio-obturator lymph node dissection. Data on patients’ demographic characteristics, pre-operative and postoperative clinical parameters and workup results, and surgical outcomes were collected to determine the overall survival using a Kaplan-Meier curve. Results: We recruited ten men and two women with a median age of 61.5 [52.8 - 68.5] years. The mean tumor diameter was 3.75 ± 1.06 cm. Three (25%) patients received adjuvant chemotherapy while eight did not. The mean surgery duration was 242 ± 45.85 minutes. Blood vessels and nerves were preserved in four (33.33%) patients during surgery. Transitional cell carcinoma was found in 10 (83.33%) patients while epidermoid carcinoma was found in two (16.67%) patients. Metastasis occurred in four (33.33%) patients while the tumor recurred in two (16.67%) patients who later died. Bricker’s ileal conduit urinary diversion was performed in 10 (83.33%) patients while the Studer neobladder was used in two (16.67%) patients. The mean duration of hospitalization was 6 ± 1.48 days. Only one patient (8.33%) developed a postoperative complication. Six (50%) of the patients died while six survived. The median overall survival was 486 days and the five-year overall survival rate was 46.47%. Conclusion: Laparoscopic cystectomy is a mini-invasive technique associated with good cancer control. When performed by well-trained staff using specialized equipment, it can be a safe and effective method of managing muscle-invasive bladder cancer.

Laparoscopic cystectomy with lymphadenectomy and ileoconduitis creation: А case report

Relevance: Radical cystectomy remains the «gold standard» of muscle-invasive and locally advanced bladder cancer treatment. The article describes the capacity and technique of laparoscopic cystoprostatectomy with lymphadenectomy and the creation of ileoconduitis in bladder cancer since the authors could not find publications on conducting laparoscopic cystoprostatectomy with the creation of an ileoconduitis in oncological and urological clinics in Kazakhstan by domestic specialists.
 The purpose was to describe an attempt to reproduce the method of open radical cystectomy laparoscopically as accurately as possible.
 Results: In the described case, the patient diagnosed with bladder cancer T2N0M0 IIst underwent surgery in the form of
 laparoscopic cystectomy with lymphadenectomy and the creation of ileoconduitis. This method of surgical intervention is minimally invasive, less traumatic, and ensures quick recovery in the postoperative period.
 Conclusion: Laparoscopic execution of radical cystectomy allows preserving the advantages of minimally invasive interventions without losing the reliability of the well-proven open surgery. Currently, the implementation of such minimally invasive surgical interventions is possible in many clinics in Kazakhstan, equipped with endoscopic video equipment, if there are specialists experienced in open surgery

Laparoscopic cystectomy with lymphadenectomy and ileoconduitis creation: А case report

Relevance: Radical cystectomy remains the “gold standard” of treatment for muscle-invasive and locally advanced
 bladder cancer. The article describes the capacity and technique of laparoscopic cystoprostatectomy with lymphadenectomy and the creation of an ileoconduitis in bladder cancer,
 since the authors could not find publications on conducting
 laparoscopic cystoprostatectomy with the creation of an ileoconduitis in oncological and urological clinics in Kazakhstan
 by domestic specialists.
 The purpose was to describe an attempt to reproduce laparoscopically the method of open radical cystectomy as accurately as possible.
 Results: In the described case, the patient diagnosed with
 the bladder cancer T2N0M0 IIst underwent surgery in the form
 of laparoscopic cystectomy with lymphadenectomy and the creation of an ileoconduitis. This method of surgical intervention is
 minimally invasive, less traumatic, and ensures quick recovery in
 the postoperative period.
 Conclusion: Laparoscopic execution of radical cystectomy
 allows preserving the advantages of minimally invasive interventions without losing the reliability of the well-proven open
 surgery. Currently, the implementation of such minimally invasive surgical interventions is possible in many clinics in Kazakhstan, equipped with endoscopic video equipment, if there are
 specialists experienced in open surgery.

V6 - Laparoscopic cystoprostatectomy - a feasible option in South-Eastern Europe?

V6 - Laparoscopic cystoprostatectomy - a feasible option in South-Eastern Europe?

Laparoscopic nerve-sparing cystoprostatectomy with intracorporeal orthotopic sigmoid neobladder formation

The following clinical case is presented: performing of minimally invasive laparoscopic nerve-sparing cystoprostatectomy with intracorporeal orthotopic sigmoid neobladder formation for patient aged 62 with invasive bladder cancer. This case proves that the performed method of urine derivation is safe and can be used as alternative to other techniques in patients who underwent radical laparoscopic cystoprostatectomy.

Laparoscopic Management of a Small Bowel Herniation from an Ileal Conduit

Bladder carcinoma can be treated with cystectomy and urinary diversion. Ileal conduit is a popular technique, originally performed with closure of all mesenteric and peritoneal defects to minimize internal herniation. Recent advances in laparoscopic and robotic techniques often leave these defects open. We present a case of a 75-year-old gentleman with a small bowel entrapment underneath an intraperitoneal ileal conduit and ureter causing obstruction. This internal hernia occurred 2 months after undergoing a DaVinci robotic-assisted laparoscopic cystoprostatectomy with an ileal conduit. Bowel obstruction is an important complication associated with the need for reoperation and patient mortality. Historical review shows a precedent for closure of the mesenteric defect, obliterating the peritoneal defect in the right lumbar gutter, and suturing the ileal conduit to the posterior peritoneum to prevent potential internal hernias. The literature involving ileal conduits is examined for consensus on the preferred method of treating these potential spaces.

Robot-Assisted Laparoscopic Cystoprostatectomy with Extended Pelvic Lymphadenectomy, Extracorporeal Enterocystoplasty, and Intracorporeal Enterourethral Anastomosis: Initial Montsouris Experience

Radical cystectomy is the gold standard for management of invasive and recurrent high-grade superficial bladder cancer. We present our initial experience with robot-assisted laparoscopic cystoprostatectomy (RALCP) with extended pelvic lymphadenectomy (epLAD) and intracorporeal enterourethral anastomosis (IEUA). A video demonstrating our technique is available online at www.liebertonline.com/end. Between April 2008 and March 2009, nine patients underwent RALCP with epLAD and IEUA at our institution. Operative technique, as described in detail (with video), was assessed for feasibility. A video demonstrating this technique is available online at www.liebertonline.com/end. Preoperative patient characteristics, operative data, as well as perioperative and pathologic outcomes were analyzed. All data were collected prospectively. Median total operative time was 270 minutes (range 210-330): 60 minutes, bilateral epLAD; 90 minutes, RALCP; 60 minutes, open enterocystoplasty; 60 minutes (range 45-90), IEUA. Median blood loss was 400 mL (range 200-900 mL). All surgical margins were negative. Median number of lymph nodes removed was 11 (range 4-21). Postoperative complications were noted in three patients and included urinoma (n = 1), pyelonephritis (n = 1), and hematoma (n = 1). RALCP is feasible and can be performed safely and effectively with acceptable operative, pathologic, and short-term clinical outcomes. More experience with longer follow-up is necessary to further assess clinical and oncologic outcomes of robotic assisted laparoscopic cystectomy for treatment of bladder cancer.

Laparoscopic Cystoprostatectomy for Radiation-Induced Hemorrhagic Cystitis

Hemorrhagic cystitis after radiotherapy is a relatively rare event, usually occurring several years after radiation treatment. It can be relentlessly progressive, and treatment options are usually suboptimal. No management strategy is fully successful, and a stepwise progression in treatment intensity is often necessary with cystectomy and urinary diversion being the final management option. Laparoscopic cystoprostatectomy with minilaparotomy ileal conduit urinary diversion was successfully performed in three patients with severe refractory hemorrhagic cystitis secondary to radiation treatment for prostate cancer. More conservative management had failed in all three patients with continued severe and life-threatening bleeding. No intraoperative complications were encountered in spite of the obliteration of tissue planes after radiation treatment. Mean operative time was 4 hours and 45 minutes, including the urinary diversion. Blood loss ranged from 50 to 200 mL. Postoperative recovery was uneventful with the exception of prolonged ileus in one patient, which resolved conservatively. Radiation treatment for prostate cancer is not an absolute contraindication for laparoscopic cystoprostatectomy, which can still be safely performed in some of these patients. Extension of this experience to patients with malignant disease remains to be evaluated.

ENDOUROLOGY Bilateral laparoscopic nephroureterectomy with open cystoprostatectomy for simultaneous upper urinary tract carcinoma

Synchronous bilateral urothelial tumors of the upper urinary tract are extremely rare and their treatment constitutes a real challenge for urologists. Whereas low grade superficial tumors can be treated using endoscopic procedures, in the case of high grade, invasive or large volume tumors bilateral radical nephroureterectomy with cystectomy is considered the standard of care. The authors present the case of large volume high grade tumors of the renal pelvices in a patient with a history of superficial bladder cancer treated by one-stage bilateral laparoscopic nephroureterectomy and open cystoprostatectomy. The aim of the study is not only to present the operative technique but also to show that the combined procedure is safe, effective and no more invasive than the operation exclusively performed laparoscopically.

Radical Cystectomy for Bladder Cancer: Morbidity of Laparoscopic Versus Open Surgery

We compared the morbidity and mortality of laparoscopic vs open surgery in radical cystectomy for bladder cancer. This prospective, nonrandomized study was conducted between January 2003 and July 2007 in 68 patients (7 women and 61 men) who underwent radical cystectomy for bladder cancer. A total of 38 cystectomies were performed laparoscopically and 30 by open surgery. Mean patient age was 68.0 +/- 9.0 years. Median preoperative American Society of Anesthesiologists score was 2 (range 1 to 3) in both groups. Intraoperative blood loss and transfusion rate were significantly lower in the laparoscopic surgery group. Postoperatively the incidence of minor complications and mortality were also significantly lower. Postoperative opioid consumption was significantly less in the laparoscopic surgery group in amount and duration. Resumption of oral fluid and solid intake as well as return to normal bowel function were significantly more rapid in the laparoscopic surgery group, and mean hospital stay was significantly shorter. Mean patient followup was 30.5 +/- 17.2 months. Laparoscopic radical cystectomy for bladder cancer has a lower morbidity rate than cystectomy by open surgery. It allows more rapid resumption of oral fluid and solid intake as well as return to normal bowel function and shorter hospital stay.

Laparoscopic Cystoprostatectomy in a Heart Transplant Recipient

A 72-year-old orthotopic cardiac transplant recipient with multiple, previously resected, cutaneous squamous cell carcinoma (SCC) presented with invasive SCC of the urinary bladder. At surgery, clot retention was managed with clot evacuation and continuous bladder irrigation to facilitate dissection. Laparoscopic cystoprostatectomy and bilateral pelvic lymph node dissection with extracorporeal ileal conduit urinary diversion were performed in 6 hours without complication. This approach minimized blood loss and allowed sufficient time out of steep Trendelenberg to reequilibrate the patient's cardiovascular system. Final pathology revealed SCC with perivesical fat invasion. This immunocompromised patient remains disease free 2 months after resection.

ROBOTIC ASSISTED LAPAROSCOPIC CYSTOPROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION

You have accessJournal of Urology1 Apr 2008ROBOTIC ASSISTED LAPAROSCOPIC CYSTOPROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION Jamey A Sarvis, Dipen J Parekh, Amanda B Reed, and Ryan K Reed Jamey A SarvisJamey A Sarvis More articles by this author , Dipen J ParekhDipen J Parekh More articles by this author , Amanda B ReedAmanda B Reed More articles by this author , and Ryan K ReedRyan K Reed More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(08)60360-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "ROBOTIC ASSISTED LAPAROSCOPIC CYSTOPROSTATECTOMY WITH EXTENDED PELVIC LYMPH NODE DISSECTION." The Journal of Urology, 179(4S), p. 125 © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 179Issue 4SApril 2008Page: 125 Advertisement Copyright & Permissions© 2008 by American Urological AssociationMetricsAuthor Information Jamey A Sarvis More articles by this author Dipen J Parekh More articles by this author Amanda B Reed More articles by this author Ryan K Reed More articles by this author Expand All Advertisement PDF DownloadLoading ...

Hand-assisted laparoscopic radical cystoprostatectomy and urethrectomy with ileal conduit construction

Hand-assisted laparoscopy was first performed in the 1990s by inserting the surgeon's finger or hand through a small tight wound. Although leakage of gas from the incision initially limited the usefulness of the technique, the hand-assisted procedures have advanced extensively since the introduction of the hand-assisted laparoscopy port. Laparoscopic procedure has only rarely been applied to radical cystoprostatectomy. Favorable reports for laparoscopic radical prostatectomy encouraged us to attempt a cystoprostatectomy under hand-assisted laparoscopy. The patient was a 70-year-old male with an invasive bladder tumor and no distant metastasis. Informed consent for undergoing hand-assisted laparoscopic radical cystoprostatectomy and ileal conduit construction was obtained. The bladder was dissected free and extracted whole through the incision for the hand port. The bilateral ureters and a loop of small intestine were withdrawn through the same incision. An ileal segment was isolated and small intestine continuity was recovered. Each ureter was anastomosed to one extreme of the ileal segment that was then reintroduced into the abdomen. The stoma was constructed through the right side port without additional incision. No intraoperative complications were observed. Recuperation was unusually quick and painless, and few postoperative analgesics were needed. Hand-assisted laparoscopic cystoprostatectomy and urinary diversion could provide the advantage of decreased postoperative morbidity without the long operation time and technical difficulty of a strictly laparoscopic procedure.

Initial Experience with Successful Totally Robotic Laparoscopic Cystoprostatectomy and Ileal Conduit Construction in Tetraplegic Patients: Report of Two Cases

To evaluate the feasibility and safety of totally robotic laparoscopic cystoprostatectomy for neurogenic bladder, with intracorporeal ileal-conduit urinary diversion in tetraplegic patients with severe neurogenic bladder complications. Two men, 41 and 38 years old, with complete post-traumatic C7-C8 quadriplegia and poor lower urinary-tract condition underwent totally transperitoneally performed cystoprostatectomy and ileal-conduit urinary diversion with robotic assistance (Da Vinci). The procedures were completed without open conversion. The total surgical time was 9.25 and 6.75 hours, respectively. There were no intraoperative complications. In the postoperative period, both patients had mild complications (pulmonary and urinary infections) that were treated successfully medically. The postoperative hospital stay was 13 days in both cases. Our results demonstrate the safety and feasibility of robot-assisted laparoscopic cystoprostatectomy with ileal-conduit urinary diversion in two tetraplegic patients.

Laparoscopic Radical Cystoprostatectomy: Our Experience in A Consecutive Series of 10 Patients with a 3 Years Follow-Up

Objective: Laparoscopic radical cystectomy is a feasible procedure but there is still controversy if laparoscopic treatment of transitional cell carcinoma (TCC) of the bladder is oncologically safe. We report our experience with laparoscopic radical cystectomy in a consecutive series of 10 male patients with a 3 years follow-up. Methods: Between June 2001 and July 2002, 10 men age 63 to 74 years (mean 68.8) underwent laparoscopic cystoprostatectomy with urinary diversion for muscle-invasive TCC or pT1 G3 TCC plus carcinoma in situ (Cis) after 2 cycles of intravesical bacille Calmette-Guerin therapy and three or more transurethral resections (delayed cystectomy). Results: Histopathology revealed 2 stage pT1N0 TCC G3 plus Cis, 1 stage pT2aN0 TCC G3 plus Cis, 1 stage pT2bN0 TCC G2, 4 stage pT2bN0 TCC G2-3, 1 stage pT2bN0 TCC G3, 1 stage pT3aN0 TCC G3. The mean follow-up is 30.4 months (range 23–36). No local recurrences, peritoneal carcinosis or trocar-site metastases occurred. Metastases presented in 4 of 10 cases (2 patients with a stage pT1N0 plus Cis and 2 patients with a stage pT2bN0 TCC) respectively after 7, 14, 16 and 28 months. These patients died respectively at 20, 18, 22 and 31 months later. One patient died for unrelated causes. Five patients are alive, free from disease. Conclusions: Laparoscopic radical cystectomy is feasible and accomplished with low morbidity. Up to now publishing data do not support a verified negative oncological effect of the laparoscopy in the treatment of bladder TCC, but our initial results seem worst than those achieved with open surgery. The experience of other Institutions will help to provide objective evaluation of this new and controvers technique because it is not clearly demonstrated that laparoscopic radical cystectomy is an oncologically safe procedure in the management of bladder TCC. Thus in our opinion it should be still considered experimental.

Hand-assisted laparoscopic cystoprostatectomy and urinary diversion.

We report the first series of patients who have undergone hand-assisted laparoscopic cystoprostatectomy and diversion (HALCD). Seven patients with muscle-invasive bladder cancer elected to have their surgery by hand-assisted laparoscopy. The bladder was excised using a hand-assisted laparoscopic technique, and the ileal conduit was constructed through the midline incision created for the hand. The operative time was relatively short (mean 7.6 hours), blood loss was low (420 mL), and the postoperative stay was short (4.6 days). Long-term follow-up is pending. Laparoscopic techniques for radical cystectomy are currently being explored at several major medical centers. Hand-assisted laparoscopy offers the distinct advantages of palpation, retraction, speed, and minimal morbidity.

Laparoscopic radical cystoprostatectomy: a technique illustrated step by step.

Laparoscopic surgery is expanding among urologists as a minimally invasive treatment and may now be applied to treat neoplasms of the pelvic organs. Laparoscopic cystoprostatectomy has still not been well codified and illustrated. We describe a technique of laparoscopic radical cystoprostatectomy that we have developed in 10 patients after practicing in laparoscopic radical prostatectomy. Between June 2001 and July 2002, 10 men with bladder cancer underwent laparoscopic cystoprostatectomy with urinary diversion. This report details step by step our 5-port transperitoneal technique with primary access to the seminal vesicles and Denonvillier's fascia, ureters detection after umbilical arteries incision, endopelvic fascia incision and dorsal vein complex control before division of the vesical and prostatic fibrovascular pedicles with a harmonic scalpel. We performed 6 orthotopic ileal neobladders, 2 sigmoid ureterostomies and 2 cutaneous ureterostomies. In all cases no conversion to open surgery was necessary. The mean time to perform the laparoscopic radical cystoprostatectomy, including the lymph node dissection, was 166 minutes (range 150-180). Mean estimated blood loss was 310 ml (range 220-440). Mean hospital stay was 8.1 days (range 7-9) for ileal orthotopic neobladder, 8 days (range 7-9) for sigmoid ureterostomy and 5 days for cutaneous ureterostomy. The mean follow up is 12.3 months (range 5-18). Two patients respectively with stage T2bN0 G2-3 and stage pT1N0 (plus carcinoma in situ) G3 transitional cell carcinoma and surgical margins tumor free had diffusive metastatic disease after 6 months. The other 8 patients are free from disease. Laparoscopic radical cystectomy is still an operation for pioneers but this procedure may be not strictly relegated to a few academic centers. In our opinion laparoscopic cystoprostatectomy is a feasible, fast, safe and easy procedure and urinary diversion may be performed with a laparoscopic, open or combined approach without reducing the advantages of laparoscopy.

Ifosfamide, Doxorubicin and Dacarbazine Chemotherapy, and Adjunctive Laparoscopic Cystoprostatectomy and External Beam Radiotherapy for Prostatic Embryonal Rhabdomyosarcoma

No AccessJournal of UrologyCLINICAL UROLOGY: Case Reports1 Dec 2002Ifosfamide, Doxorubicin and Dacarbazine Chemotherapy, and Adjunctive Laparoscopic Cystoprostatectomy and External Beam Radiotherapy for Prostatic Embryonal Rhabdomyosarcomais corrected byErrata H. CHALCHAL, T.H.P. TAI, E. TSE, E.C. ALPORT, and M. SALIM H. CHALCHALH. CHALCHAL More articles by this author , T.H.P. TAIT.H.P. TAI More articles by this author , E. TSEE. TSE More articles by this author , E.C. ALPORTE.C. ALPORT More articles by this author , and M. SALIMM. SALIM More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64195-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Ifosfamide, Doxorubicin and Dacarbazine Chemotherapy, and Adjunctive Laparoscopic Cystoprostatectomy and External Beam Radiotherapy for Prostatic Embryonal Rhabdomyosarcoma." The Journal of Urology, 168(6), p. 2545 References 1 : Prostate embryonal rhabdomyosarcoma in adults. A clinicopathologic review. Cancer1992; 69: 755. Crossref, Medline, Google Scholar 2 : The Intergroup Rhabdomyosarcoma Study. I. A final report. Cancer1988; 61: 209. Crossref, Medline, Google Scholar From the Allan Blair Cancer Centre, University of Saskatchewan, Regina, Saskatchewan, Canada© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Kieran K and Shnorhavorian M (2016) Current standards of care in bladder and prostate rhabdomyosarcomaUrologic Oncology: Seminars and Original Investigations, 10.1016/j.urolonc.2015.12.012, VOL. 34, NO. 2, (93-102), Online publication date: 1-Feb-2016. Related articlesJournal of Urology9 Nov 2018Errata Volume 168Issue 6December 2002Page: 2545 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostatic neoplasmsradiotherapyprostatectomydrug therapy, combinationrhabdomyosarcoma, embryonalMetricsAuthor Information H. CHALCHAL More articles by this author T.H.P. TAI More articles by this author E. TSE More articles by this author E.C. ALPORT More articles by this author M. SALIM More articles by this author Expand All Advertisement PDF downloadLoading ...

LAPAROSCOPIC INTRACORPOREALLY CONSTRUCTED ILEAL CONDUIT AFTER PORCINE CYSTOPROSTATECTOMY

We present our technique of laparoscopic ileal conduit creation after cystoprostatectomy in a porcine model performed in a completely intracorporeal manner. After developing the technique in 5 acute animals laparoscopic cystoprostatectomy with intracorporeally performed ileal conduit urinary diversion was performed in 10 surviving male pigs. A 5-port transperitoneal technique was used. All steps of the technique applied during open surgery were duplicated intracorporeally. Specifically cystectomy, isolation of an ileal conduit, restoration of bowel continuity and mucosa-to-mucosa stented bilateral ileoureteral anastomosis formation were performed by exclusively intracorporeal laparoscopic techniques. Surgery was successful in all 10 study animals without intraoperative or immediate postoperative complications. Blood loss was minimal and average operative time was 200 minutes. Stenosis of the end ileal stoma specifically at the skin level was noted in 6 animals. Three deaths occurred 2 to 3 weeks postoperatively. At sacrifice renal function was normal in all surviving animals. No ileo-ureteral anastomotic strictures were noted on pre-sacrifice radiography of the loop or at autopsy examination of the anastomotic sites. Laparoscopic ileal conduit urinary diversion after cystoprostatectomy may be performed completely intracorporeally in the porcine model. Clinical application of this technique is imminent.