"Minho Technique" for Laparoscopic Radical Cystectomy with Intracorporeal Ileal Conduit

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Radical cystectomy (RC) with ileal conduit (IC) is a primary treatment for muscle-invasive bladder cancer (MIBC).
• Laparoscopic RC (LRC) with intracorporeal IC (IIC) is technically challenging but offers potential benefits.
• Simplifying this complex procedure is crucial for wider adoption.

Purpose of the Study:

• To demonstrate a simplified, step-by-step technique for 4-port laparoscopic radical cystectomy with intracorporeal ileal conduit.
• To present a modified approach emphasizing immediate posterior dissection for enhanced efficiency.

Main Methods:

• A 4-port laparoscopic radical cystectomy with intracorporeal ileal conduit and Bricker uretero-ileal anastomosis was performed.
• The technique incorporates an immediate and complete posterior dissection, inspired by the Montsouris approach.

Main Results:

• The procedure was successfully performed on a 70-year-old patient with a 5 cm MIBC.
• Postoperative recovery was uneventful, with diet and ambulation initiated on day 2.
• At 24 months, the patient remains disease-free without complications like hydronephrosis or recurrence.

Conclusions:

• Laparoscopic radical cystectomy with intracorporeal ileal conduit, when performed using a standardized technique, is feasible and safe.
• This 4-port approach utilizes standard materials without significantly increasing operative time.
• The technique demonstrates no compromise in oncological outcomes or functional results.