Laparoscopic radical cystectomy with intracorporeal ileal conduit diversion: Modified techniques and long-term outcomes

Aim: The aim of the present study was to assess the efficacy and long-term outcomes of laparoscopic radical cystectomy (LRC) with ileal conduit urinary diversion for organ-confined bladder carcinoma, undertaken intracorporeally using our modified techniques. Patients and Methods: Seven male patients underwent LRC with intracorporeal ileal conduit diversion only using pure laparoscopic techniques. Results: All procedures were completed without open conversion or intraoperative complications. The surgical margins of the specimens were negative in all patients. The mean duration of surgery was 7h (range: 6-8.5), the mean blood loss was 420mL (range: 330-750) and the mean postoperative hospital stay was 9days (range: 7-15). At a mean follow up of 44months (range: 36-49), one patient developed intestinal obstruction requiring an operation after 32months. Another developed local oncological recurrence in the posterior urethra. One patient had bilateral inguinal lymphatic metastases, and another had hydronephrosis of the right kidney without symptoms. These complications and oncological recurrences were all found after 2years. No patient has port site metastases and distant metastases to date. Conclusions: LRC with ileal conduit diversion undertaken completely intracorporeally is a safe and feasible option for organ-confined bladder carcinoma. Our modified techniques are helpful to simplify the procedure.