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[Radical cystectomy and laparoscopic ileal conduit].

Authors: E, Sánchez de Badajoz; J L, Gallego Perales; A, Reche Rosado; J M, Gutiérrez de la Cruz; A, Jiménez Garrido;

[Radical cystectomy and laparoscopic ileal conduit].

Abstract

Herein we describe for the first time a laparoscopic cystectomy procedure and an ileal conduit that were performed in a single session in a patient with a tumor infiltrating the right wall. The procedure starts by releasing the ureters from the iliac junction up to a point close to the bladder. The peritoneum is incised superiorly at the level of the urachus and we proceed until the space of Retzius and the lateral walls are released. The vesicouterine plica is then incised and the bladder wings are dissected with the Endo-GIA. With a straight dissector, the urethra is released and cut until the bladder is completely free within the abdominal cavity. The trocar is removed from the right flank, the incision is extended up to about 4 cms and the bladder is removed. The right ureter and an ileal loop are then brought out through the incision on the right flank. A segment of intestine is isolated and intestinal continuity is reestablished using mechanical sutures. Then the ureter is implanted at one end of the isolated intestinal segment. The other end of the segment of intestine is taken to the left flank and anastomosed extracorporeally in a similar manner to the ureter of that side. The ileal conduit is positioned transversely so it is unnecessary to take the ureter to the opposite side. Finally, a stoma is created, which the patient desired done in the left side, and the procedure is completed. Although the operating time is long, the surgical insult is minimal because the McBurney type flank incisions cause little injury to the abdominal wall.

Related Organizations
Keywords

Urinary Bladder Neoplasms, Ileum, Humans, Female, Laparoscopy, Middle Aged, Urinary Diversion, Cystectomy

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    influence
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citations
The total number of citations received by all articles of the researcher of interest.
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
49
Top 10%
Top 10%
Average
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