Laparoscopic radical cystectomy with ileal conduit diversion: The first case report in Thailand

Objective: To report the authors' first experience on a surgical technique for laparoscopic radical cystectomy with ileal conduit diversion. Material and Method: 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.