Creation of the miami pouch during laparoscopic-assisted pelvic exenteration: the initial experience.
OBJECTIVE
To describe the initial experience of laparoscopic hand-assisted Miami pouch in a group of patients undergoing pelvic exenterations for pelvic malignancies.


METHODS
Thirteen female patients underwent laparoscopic-assisted pelvic exenteration in our center between September 2000 and November 2007. Six of them had the Miami pouch created for urinary diversion. The continent diversion was created extracorporeally through a right iliac fossa minilaparotomy.


RESULTS
The mean total operative time for the laparoscopic-assisted exenteration and reconstruction was 382 minutes (range, 270-480 minutes), but specifically for the Miami pouch, it took a mean time of 106 minutes (range, 90-130 minutes). Four patients (66.7%) had postoperative urinary tract infection that resolved with antibiotics. One patient had a ureteral stenosis requiring stenting and one had a Miami pouch cutaneous fistula that required a fistulectomy. The mean follow-up was 23 months (range, 9-48 months). All patients were continent and were able to self-catheterize approximately 3 to 6 times/d.


CONCLUSIONS
It is technically feasible to incorporate the creation of the Miami continent urinary pouch through a minilaparotomy during laparoscopic pelvic exenteration without compromising the benefits of laparoscopic surgery.
Ferron
Gwénaël
G
Institut Claudius Regaud, Department of Surgical Oncology, Toulouse, France. ferron.gwenael@claudiusregaud.fr
Lim
Timothy Yong Kuei
TY
Pomel
Christophe
C
Soulie
Michel
M
Querleu
Denis
D
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010385:Pelvic Exenteration; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent; D002583:Uterine Cervical Neoplasms / Q000601:surgery*