Hand-assisted laparoscopic cystoprostatectomy and urinary diversion
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David E McGinnis1, Scott G Hubosky, Leigh S Bergmann
1Department of Urology, Bryn Mawr Hospital, Bryn Mawr, Pennsylvania, USA. demcginnismd@hotmail.com
Purpose:
We report the first series of patients who have undergone hand-assisted laparoscopic cystoprostatectomy and diversion (HALCD).
Patients And Methods:
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.
Results:
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.
Conclusion:
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.