[Laparoendoscopic single-site surgery radical cystectomy with orthotopic taenia myectomy sigmoid neobladder: initial report].
OBJECTIVE
To report the first case and detailed techniques of laparoendoscopic single-site surgery (LESS) radical cystectomy with orthotopic taenia myectomy sigmoid neobladder for organ-confined bladder cancer.


METHODS
A 74-year-old man presented with gross hematuria for 2 months and biopsy revealed bladder cancer. LESS radical cystectomy and bilateral pelvic lymphadenectomies were performed using a single multilumen port inserted through a solitary 3.5 cm lower abdominal incision with conventional laparoscopic instruments. The taenia myectomy sigmoid pouch was then constructed by open procedure.


RESULTS
The total operative time was 9.5 h, and the LESS procedure lasted for about 5.5 h. No other port incision was added. The final pathology revealed urothelial carcinoma. The estimated intraoperative blood loss was 600 ml with blood transfusion of 400 ml. The pelvic lymph nodes and the surgical margins of the ureters and urethra were all free of tumor invasion. No water electrolyte and metabolic acid-base balance disorders were observed perioperatively. The neobladder capacity was about 280 ml, with a residual urine volume of 10 ml and peak flow rate of 11.1 ml/s 3 months postoperatively.


CONCLUSIONS
Although with a steep learning curve, LESS surgery can be a less invasive and promising alternative to muscle-invasive bladder carcinoma.
Liu
Chun-xiao
CX
Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China. liuchx888@hotmail.com
Xu
A-bai
AB
Chen
Bin-shen
BS
Zheng
Shao-bo
SB
Li
Hu-lin
HL
Xu
Ya-wen
YW
D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent