Laparoendoscopic single-site radical cystectomy and pelvic lymph node dissection: Initial experience and 2-year follow-up

Jihad H. Kaouk, Raj K. Goel, Michael A. White, Wesley White, Riccardo Autorino, Georges Pascal Haber, Steven C. Campbell

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

OBJECTIVE: To report the first series of laparoendoscopic single-site surgery for radical cystectomy and bilateral pelvic lymph node dissection. The development of laparoendoscopic single-site surgery and its application to urothelial malignancy has not been previously evaluated. METHODS: A novel, single multichannel port and flexible laparoscopic instruments and laparoscope were used for all procedures. The eligible patients had transitional cell carcinoma that was muscle invasive or refractory to intravesical therapy. Locally advanced disease, previous abdominal or pelvic surgery or radiotherapy, or those desiring orthotopic reconstruction were excluded. No additional ports were needed, and lymphadenectomy was performed using an extended template up to the aortic bifurcation. RESULTS: A total of 3 patients (2 men and 1 woman) underwent radical cystectomy with bilateral pelvic lymph node dissection. All the procedures were completed successfully. All patients underwent extracorporeal urinary diversion by way of extension of the umbilical port site. The operative time was 315 ± 40 minutes, and the blood loss was minimal (217 ± 29 mL). The pathologic evaluation revealed negative margins and negative lymph node involvement (mean number of nodes 16 ± 3). All patients were discharged within 1 week (6 ± 1 days) with minimal postoperative pain according to the visual analog pain scale (0-1 of 10). At a minimum of 2 years of follow-up (range 24-26 months), no evidence of recurrent or metastatic disease was detected. CONCLUSIONS: Laparoendoscopic single-site surgery for radical cystectomy and bilateral pelvic lymph node dissection is feasible and safe for select patients. Adequate lymph node dissection was possible through a single multichannel port. The long-term oncologic evaluation of these patients awaits; however, the preliminary outcomes have been promising.

Original languageEnglish (US)
Pages (from-to)857-861
Number of pages5
JournalUrology
Volume76
Issue number4
DOIs
StatePublished - Oct 1 2010
Externally publishedYes

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Cystectomy
Lymph Node Excision
Laparoscopes
Umbilicus
Urinary Diversion
Transitional Cell Carcinoma
Pain Measurement
Operative Time
Postoperative Pain
Radiotherapy
Lymph Nodes
Muscles
Neoplasms

All Science Journal Classification (ASJC) codes

  • Urology

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Laparoendoscopic single-site radical cystectomy and pelvic lymph node dissection : Initial experience and 2-year follow-up. / Kaouk, Jihad H.; Goel, Raj K.; White, Michael A.; White, Wesley; Autorino, Riccardo; Haber, Georges Pascal; Campbell, Steven C.

In: Urology, Vol. 76, No. 4, 01.10.2010, p. 857-861.

Research output: Contribution to journalArticle

Kaouk, Jihad H. ; Goel, Raj K. ; White, Michael A. ; White, Wesley ; Autorino, Riccardo ; Haber, Georges Pascal ; Campbell, Steven C. / Laparoendoscopic single-site radical cystectomy and pelvic lymph node dissection : Initial experience and 2-year follow-up. In: Urology. 2010 ; Vol. 76, No. 4. pp. 857-861.
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