Laparoscopic Radical Cystectomy with Ileal Conduit Diversion: The First Case Report in Thailand
Kittinut Kijvikai MD*, Suthep Patcharatrakul MD**, Wisoot Kongchareonsombat MD***, Charuspong Dissaranan MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Division of Urology, Department of Surgery, Police General Hospital *** Division of Urology, Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital
Objective : To report the authors’ first experience on a surgical technique for laparoscopic radical cystectomy
with ileal conduit diversion.
Materials and Methods : A 55 year-old man, weighing 65 Kg with histology proven T 2 transitional cell
carcinoma of the urinary bladder underwent laparoscopic radical cystectomy with ileal conduit diversion.
The cystoprostatectomy was performed by laparoscopic technique, whereas ileal conduit and stroma were
performed through a mini-laparotomy.
Results : The procedure was performed successfully without open conversion. The operation time was 350 min.
Estimated blood loss was 1,100 ml. Only 6 mg morphine was needed for postoperative pain relief. The surgical
margins were free from tumor. The hospital stay was 8 days. The patient returned to his normal activities 3
weeks after surgery.
Conclusion : Laparoscopic radical cystectomy with ileal conduit diversion was a feasible and safe operation
for muscle invasive carcinoma of the urinary bladder. However, the procedure needed a steep learning curve
and should be performed in centers having experience in laparoscopic surgery.
Keywords : Radical cystectomy, Ileal conduit diversion, Laparoscopy
