Laparoscopic Cystectomy and Laparoscopically Assisted Orthotopic Neobladder

  • Christophe Vaessen

Cystectomy is the treatment of choice for localized urothelial carcinoma of the bladder involving the smooth muscle or for superficial bladder cancer uncontrolled by conservative treatment [1].

The mortality and morbidity is well known, especially in patients with a high American Society of Anesthesiologists (ASA) score [2].

Laparoscopic procedure for cystectomy have been described, either totally intracorporeal or with combined procedure [3,4,5,6]. We describe in this chapter the different steps of a combined procedure for laparoscopic cystoprostatectomy with orthotopic reconstruction. With the goal of shortening the operative time, we have chosen a combined technique of a laparoscopic cystoprostatectomy and an open reconstruction of the bladder. This permits combining the advantages of laparoscopy and the rapidity of open surgery. The advantages of laparoscopy are the magnification, the decrease in pain, and the maintenance of the immune wall. It is also an almost bloodless surgery. All these factors contribute to the decrease in the morbidity of this surgery and shorten the hospital stay [5,7]. It also contributes to a decrease in the required analgesia [4,7,8].


Radical Cystectomy Urinary Diversion Ileal Conduit Superficial Bladder Cancer Laparoscopic Radical Cystectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Dalbagni G, Genega E, Hashibe M, et al (2001) Cystectomy for bladder cancer: a contemporary series. J Urol 165(4):1111–1116.PubMedCrossRefGoogle Scholar
  2. 2.
    Malavaud B, Vaessen C, Mouzin M, et al (2001) Complications for radical cystectomy: impact of the American Society of Anesthesiologists Score. Eur Urol 39:79–84.PubMedCrossRefGoogle Scholar
  3. 3.
    Denewer A, Kotb S, Hussein O, El-Maadawy M (1999) Laparoscopic assisted cystectomy and lymphadenectomy for bladder cancer: initial experience. World J Surg 23(6):608–611.PubMedCrossRefGoogle Scholar
  4. 4.
    Gaboardi F, Simonato A, Galli S, Lissiani A, Gregori A, Bozzola A (2002) Minimally invasive laparoscopic neobladder. J Urol 168(3):1080–1083.PubMedCrossRefGoogle Scholar
  5. 5.
    Puppo P, Perachino M, Ricciotti G, et al (1995) Laparoscopically assisted transvaginal radical cystectomy. Eur Urol 27(1):80–84.PubMedGoogle Scholar
  6. 6.
    Simionato A, Gregori A, Lissiani A, et al (2003) Laparoscopic radical cystoprostatectomy: a technique illustrated step by step. Eur Urol 44:132–138.CrossRefGoogle Scholar
  7. 7.
    Turk I, Deger S, Winkelmann B, Loening SA (2001) Laparoscopic radical cystectomy with continent urinary diversion (rectal sigmoid pouch) performed completely intracorporeally: the initial 5 cases. J Urol 165(6 pt 1):1863–1866.PubMedCrossRefGoogle Scholar
  8. 8.
    Abdel-Hakim AM, Bassiouny F, Abdel Azim MS, et al (2002) Laparoscopic radical cystectomy with orthotopic neobladder. J Endourol 16(6):377–381.PubMedCrossRefGoogle Scholar
  9. 9.
    Gill IS, Kaouk JH, Meraney AM, et al (2002) Laparoscopic radical cystectomy and continent orthotopic ileal neobladder performed completely intracorporeally: initial experience. J Urol 168(1):13–18.PubMedCrossRefGoogle Scholar
  10. 10.
    Gupta NP, Gill IS, Fergany A, Nabi G (2002) Laparoscopic radical cystectomy with intracorporeal ileal conduit diversion: five cases with a 2-year follow-up. BJU Int 90(4):391–396.PubMedCrossRefGoogle Scholar
  11. 11.
    Gill IS, Fergany A, Klein EA, et al (2000) Laparoscopic radical cystoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases. Urology 56(1):26–29.PubMedCrossRefGoogle Scholar
  12. 12.
    Matin SF, Gill IS (2002) Laparoscopic radical cystectomy with urinary diversion: completely intracorporeal technique. J Endourol 16(6):335–341.PubMedCrossRefGoogle Scholar
  13. 13.
    Maxwell-Armstrong CA, Robinson MH, Scholefield JH (2000) Laparoscopic colorectal cancer surgery. Am J Surg 179(6):500–507.PubMedCrossRefGoogle Scholar
  14. 14.
    Taragona EM, Balague C, Knook MM, Trias M (2000) Laparoscopic surgery and surgical infection. Br J Surg 87(5):536–544.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2009

Authors and Affiliations

  • Christophe Vaessen
    • 1
  1. 1.Groupe HospitalierService d’Urologie et TransplantationParisFrance

Personalised recommendations