Fast and safe closing of urethra during laparoscopic radical cystectomy.
OBJECTIVE
To present a simple alternative technique to close the membranous urethra during laparoscopic radical cystectomy.


METHODS
A series of 18 laparoscopy-assisted cystectomies were performed in our institute from November 2002 to May 2005. In order to prevent neoplastic-cell spillage, in 14 of these patients, the membranous urethra was closed with Hem-o-lok clips after careful dissection of the urethra and withdrawal of the bladder catheter.


RESULTS
In all cases, one or two Hem-o-lok clips were easily, safely, and quickly positioned. The remaining length of the membranous urethra was sufficient for anastomosis with the neobladder if appropriate. In follow-up (mean 14 months), no local recurrence has been recorded.


CONCLUSIONS
The closing of the membranous urethra with Hem-o-lok clips during laparoscopy-assisted cystectomy is in our experience a simple, fast, safe, and effective alternative that should be considered when laparoscopic radical cystectomy is performed.
Porpiglia
Francesco
F
Department of Urology, University of Turin, San Luigi Hospital, Orbassano, TO, Italy. porpiglia@libero.it
Renard
Julien
J
Billia
Michele
M
Cossu
Marco
M
Morra
Ivano
I
Terrone
Carlo
C
Scarpa
Roberto Mario
RM
D015653:Cystectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009366:Neoplasm Seeding; D014521:Urethra / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*