Videoendoscopically assisted transvaginal radical cystectomy.

Area of Science:

• Uro-oncology
• Minimally invasive surgery
• Gynecologic oncology

Background:

• Anterior pelvic exenteration is a complex surgical procedure for advanced pelvic cancers.
• The combined transvaginal and laparoscopic approach offers potential benefits for specific patient populations.
• Orthotopic neobladders have reduced the indications for traditional transvaginal cystectomy.

Purpose of the Study:

• To describe the experience and outcomes of anterior pelvic exenteration using a combined transvaginal and laparoscopic approach for bladder cancer in women.
• To evaluate the feasibility, safety, and efficacy of this minimally invasive technique.

Main Methods:

• Retrospective review of patients undergoing anterior pelvic exenteration for bladder cancer.
• Combined transvaginal and laparoscopic surgical technique.
• Assessment of intraoperative complications, postoperative recovery, and survival.

Main Results:

• Four cases performed in the last 3 years.
• No major intraoperative complications.
• Average hospital stay of 8.6 days with no postoperative complications; minimum survival of 13 months with all patients alive.

Conclusions:

• The combined transvaginal and laparoscopic approach for anterior pelvic exenteration is feasible and yields satisfactory outcomes in selected women with bladder cancer.
• This technique requires specialized expertise in videoendosurgery and is best suited for centers with established minimally invasive surgical programs.
• Despite reduced indications, the procedure remains a viable option with good oncological and functional results.