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Two-port laparoscopic radical cystectomy with reusable umbilical system: a feasibility study
Javier C Angulo1, Felipe Cáceres1, Pedro M Cabrera1
1Servicio de Urología, Hospital Universitario de Getafe, Madrid, Spain; Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Laureate International Universities, Madrid, Spain.
This study shows that a two-port laparoscopic radical cystectomy (2-port LRC) is a safe and effective minimally invasive option for muscle-invasive bladder cancer, offering good oncologic and functional results with reduced pain.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Muscle-invasive bladder cancer (MIBC) necessitates radical cystectomy.
- Minimally invasive approaches aim to reduce morbidity associated with traditional open surgery.
- Laparoscopic radical cystectomy (LRC) offers potential benefits but can be technically challenging.
Purpose of the Study:
- To describe the technique of a novel two-port laparoscopic radical cystectomy (2-port LRC).
- To report the oncologic and functional outcomes of 2-port LRC in patients with MIBC.
- To evaluate the feasibility and safety of this minimally invasive approach.
Main Methods:
- A prospective study involving 20 patients with MIBC undergoing 2-port LRC between November 2011 and October 2012.
- Standardization of the 2-port LRC technique, lymph node dissection, and urinary diversion (ileal conduit or neobladder).
- Extracorporeal urinary diversion and follow-up exceeding one year.
Main Results:
- The 2-port LRC procedure demonstrated a median operative time of 335 minutes and estimated blood loss of 337 mL.
- Positive surgical margins occurred in 5% of cases, with pathological staging ranging from pT0 to pT4.
- Major complications occurred in 10% of patients, and the neobladder continence rate was high (91.7% daytime, 75% nighttime).
Conclusions:
- Umbilical 2-port LRC is a feasible and safe technique for MIBC.
- It offers good oncologic control, favorable functional outcomes, and low postoperative pain.
- 2-port LRC represents an acceptable alternative for minimally invasive radical cystectomy.
