[Laparoendoscopic radical cystectomy with orthotopic ileal neobladder through umbilical single port].
BACKGROUND
Radical cystectomy with orthotopic derivation is one of the most complex urological techniques, although laparoscopic surgery has made this procedure increasingly less invasive.


OBJECTIVE
To provide an up-dated review of the single port approach to carry out radical surgery due to bladder cancer.


METHODS
A comprehensive review of the literature was performed using Medline and Embase to discover the accumulated experience of the viability of carrying out laparoendoscopic radical cystectomy, pelvic lymphadenectomy and orthotopic neobladder using the laparoendoscopic single site surgery (LESS) approach. Our experience with this approach is also presented and the technique used with the reusable KeyPort(®) system developed by Richard Wolf is described.


RESULTS
Radical treatment of bladder cancer is possible in men and women using a single port and even performance of ileal neobladder, as reconstructive procedure in these patients. The surgical technique, post-operative cares and result obtained in our center are described. The accumulated experience worldwide describes 25 cases of radical cystectomy performed using different single port systems, 14 of them with orthotopic intestinal neobladder.


CONCLUSIONS
The KeyPort(®) umbilical cystectomy constitutes in our setting the least possible invasive alternative to efficiently treat muscle-invasive bladder cancer, with excellent esthetic result, minimum post-operative pain and short hospital stay. The umbilical scar decreases the analgesic requirements and it ends up being practically invisible. This supposes an important step in the development of the minimally invasive surgery for bladder cancer.
Hospital Universitario de Getafe, Fundación para la Investigación Biomédica, Servicio Madrileño de Salud, Universidad Europea de Madrid, Spain. jangulo.hugf@salud.madrid.org
J C
JC
Angulo
F
F
Cáceres
I
I
Arance
I
I
Romero
F
F
Ramón De Fata
P M
PM
Cabrera
D002921:Cicatrix / Q000517:prevention & control; D015653:Cystectomy / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome; D014472:Umbilicus; D014547:Urinary Diversion / Q000379:methods*