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Laparoscopic radical cystectomy with ileal conduit diversion: the first case report in Thailand
Kittinut Kijvikai1, Suthep Patcharatrakul, Wisoot Kongchareonsombat
1Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Rd, Tungphyatai, Rajathevee, Bangkok 10400, Thailand. kittinutk@hotmail.com
Objective:
To report the authors' first experience on a surgical technique for laparoscopic radical cystectomy with ileal conduit diversion.
Material And Method:
A 55 year-old man, weighing 65 Kg with histology proven T 2 transitional cell carcinoma of the urinary bladder underwent laparoscopic radical cystectomy with ileal conduit diversion. The cystoprostatectomy was performed by laparoscopic technique, whereas ileal conduit and stroma were performed through a mini-laparotomy.
Results:
The procedure was performed successfully without open conversion. The operation time was 350 min. Estimated blood loss was 1,100 ml. Only 6 mg morphine was needed for postoperative pain relief. The surgical margins were free from tumor. The hospital stay was 8 days. The patient returned to his normal activities 3 weeks after surgery.
Conclusion:
Laparoscopic radical cystectomy with ileal conduit diversion was a feasible and safe operation for muscle invasive carcinoma of the urinary bladder. However, the procedure needed a steep learning curve and should be performed in centers having experience in laparoscopic surgery.