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LESS radical cystectomy

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dc.contributor.author Angulo Cuesta, Javier
dc.contributor.author Cáceres Jiménez, Felipe
dc.contributor.author Cabrera Castillo, Pedro Manuel
dc.contributor.editor Haber, Georges-Pasca
dc.contributor.editor Kaouk, Jihad H.
dc.contributor.editor Stein, Robert J.
dc.date.accessioned 2018-05-24T10:25:25Z
dc.date.available 2018-05-24T10:25:25Z
dc.date.issued 2017
dc.identifier.citation Angulo, J. C., Cáceres, F., & Cabrera, P. M. (2017). LESS radical cystectomy. In Atlas of Laparoscopic and Robotic Single Site Surgery (pp. 151-168).New York: Humana Press. DOI: 10.1007/978-1-4939-3575-8_15 spa
dc.identifier.isbn 9781493935758
dc.identifier.issn 9781493935734
dc.identifier.uri http://hdl.handle.net/11268/7273
dc.description.abstract Laparoscopic surgery made radical cystectomy and urinary diversion a less invasive procedure but still remains one of the most complex urological techniques, prone to high rate of complications. This chapter provides a comprehensive review of the accumulated experience to convert conventional five-port laparoscopic radical cystectomy plus 10–12-cm midline minilaparotomy for specimen retrieval into laparoendoscopic single-site (LESS) radical cystectomy, pelvic lymphadenectomy, and permanent urinary diversion. Different approaches are presented. We describe in detail our experience with two-port approach using a reusable umbilical multichannel platform with curved instruments provided with double rotation system and an accessory 10-mm port placed in the right iliac fossa to overcome the current limitations of a pure single-port technique at a reasonable time and cost. Specimen extraction through the vagina in females makes unnecessary to extent the umbilical incision, and in candidates for ileal conduit, the accessory port is converted into the ileostomy orifice. If an orthotopic reservoir is preferred, the neobladder can be performed extracorporeally outside the umbilicus and, once completed, reintroduced to be anastomosed to the urethra. Perioperative outcomes, postoperative visual analogue pain scale (VAPS), and short-term morbidity confirm umbilical cystectomy which constitutes the least invasive alternative to efficiently treat muscle-invasive bladder cancer, with excellent esthetic result and patient recovery, low postoperative pain, and satisfactory hospital stay. The umbilical scar decreases the analgesic requirements and becomes practically invisible. We definitely believe LESS radical cystectomy with reusable platforms is an important step in the development of minimally invasive surgery for bladder cancer because the abdominal wall is damaged less than with any other technique. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.publisher Humana Press spa
dc.relation.ispartofseries Current clinical urology spa
dc.title LESS radical cystectomy spa
dc.type bookPart spa
dc.description.impact No data (2017) spa
dc.identifier.doi 10.1007/978-1-4939-3575-8_15
dc.rights.accessRights closedAccess spa
dc.subject.uem Vejiga spa
dc.subject.uem Cáncer spa
dc.subject.uem Cirugia spa
dc.subject.unesco Cáncer spa
dc.subject.unesco Cirugía spa
dc.description.filiation UEM spa
dc.relation.publisherversion http://ezproxy.universidadeuropea.es/login?url=http:/ /dx.doi.org/10.1007/978-1-4939-3575-8_15 spa
dc.peerreviewed Si spa


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