Laparoscopic radical cystectomy with urinary diversion: what is the optimal technique?

Laparoscopic prostatectomy has become a standardized procedure; consequently, many urologic surgeons have mastered it. Using the knowledge gained from this procedure, some laparoscopic urologic surgeons have also been successfully performing laparoscopic radical cystectomy. We review the current literature to determine the optimal technique for laparoscopic radical cystectomy.

Three techniques for the extirpative aspect of laparoscopic radical cystectomy have been described: robot-assisted, hand-assisted and pure laparoscopic surgery. Creation of the urinary bladder has been performed via both intracorporeal and extracorporeal techniques with more recent studies favoring the extracorporeal creation of the urinary diversion.

Laparoscopic radical cystectomy has become a standard procedure at many laparoscopic centers worldwide. The procedure is feasible with reproducible results. It appears to offer the patient all the advantages of other minimally invasive surgeries with respect to postoperative recovery.