THE FIRST REPORT OF LAPAROSCOPIC RADICAL CYSTECTOMY IN GEORGIA

Bladder cancer is the ninth most commonly diagnosed malignant tumor worldwide. Radical cystectomy is the standard surgical treatment for non-metastatic, muscle-invasive bladder cancer and a recommended treatment of choice in a subset of highest-risk patients with non-muscle invasive disease. Recently, laparoscopic radical cystectomy has become an attractive alternative to an open counterpart and many centers worldwide have reported their early experiences with the technique. Laparoscopic radical cystectomy is a technically challenging procedure and current recommendations still consider it, with or without robotic assistance, to be experimental due to absence of long-term data on oncological and functional outcomes and possible selection bias in the reported series. In this paper, we report the case of a 61 year-old male with a muscle-invasive recurrence of bladder cancer, who underwent laparoscopic radical cystectomy at the National Centre of Urology in Tbilisi, Georgia. This is the first such procedure performed in Georgia and most of the former Soviet countries, with the exception, to our knowledge, of only the Russian Federation. The technique of laparoscopic radical cystectomy with simultaneous prepubic urethrectomy, extended pelvic lymph node dissection, and extracorporeal urinary diversion in the form of an ileal conduit is described. Laparoscopic radical cystectomy is a feasible minimally-invasive alternative to the standard open surgery when performed by experienced surgeons in selected patients. We deem the introduction of the technique a step forward in the field of minimally invasive urology in Georgia.