title: [Laparoscopic radical cystectomy with extracorporeal creation of a "Y" shaped orthotopic ileal neobladder using non-reabsorbable mechanical suture (Fontana)].
abstract: BACKGROUND
  We describe the technique and present the preliminary results of the laparoscopic radical cystectomy technique with the extracorporeal creation of a "y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture (Fontana).
  
  
  METHODS
  We describe the technique step by step and we present a series of 15 patients that underwent this surgery between November 2005 and August 2009, with special emphasis on the duration of the surgery, urinary diversion time, intraoperative and postoperative complications, daytime and night time continence and the frequency of postoperative micturition.
  
  
  RESULTS
  The mean follow-up of the series was 24 months (6-32). The mean duration of surgery was 280 (range 210-345) minutes and the mean urinary diversion time was 54.5 (range 40-75) minutes. There were no intraoperative complications and the average hospitalization time was 7 (range 5-15) days. During the follow-up, there were 5 late postoperative complications, 2 cases of urinary infection with good response to antibiotic treatment and 3 uretero-neovesical anastomosis strictures, which were treated with percutaneous balloon dilation, with a good functional result. No lithiasis was found in the neobladder. Complete daytime continence was obtained in 13/14 patients (92.9%) and complete night time continence in 6/14 (42.9%). One patient (6.7%) required clean intermittent self-catheterization as the patient did not micturate spontaneously.
  
  
  CONCLUSIONS
  The creation of a "Y" shaped ileal orthotopic neobladder using non-absorbable mechanical suture is a feasible, fast and safe technique and it provides promising functional results. Further follow-up is required to determine its long-term results.
authors.affiliation: Departamento de Urología, Clínica Indisa, Santiago, Chile. octavio.castillo@indisa.cl
authors.forename: O A
authors.initials: OA
authors.lastname: Castillo
authors.forename: R
authors.initials: R
authors.lastname: Campos
authors.forename: I
authors.initials: I
authors.lastname: Vidal
authors.forename: A
authors.initials: A
authors.lastname: Fonerón
authors.forename: G
authors.initials: G
authors.lastname: Rubio
authors.forename: E
authors.initials: E
authors.lastname: Landerer
authors.forename: R
authors.initials: R
authors.lastname: Gómez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D015653:Cystectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods*; D013537:Sutures; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology; D016476:Urinary Reservoirs, Continent; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology