Internal Bladder Retractor for Laparoscopic Cystectomy in the Female Patient

Chiu, Allen W.; Radhakrishnan, Vijayan; Lin, Chia Hsiang; Huan, Steve K.; Wu, Ming

doi:10.1016/s0022-5347(05)64478-3

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…From these experiences, we learned several tricks to facilitate the operation. The countertraction provided by an internal bladder retractor made the dissection easier along the perivesical plane [13] . The concept of identifying a novel lateral dissecting plane helped the surgeon to easily control the perivesical structures ( fi g. 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The puboprostatic ligament was incised with endo-scissors, and the deep venous complex was controlled, either by automatic stapler or a bipolar cauterizer -Ligasure (Tyco, Norwalk, Conn., USA). To facilitate the dissection surrounding the urinary bladder, an internal bladder retrac- tor was innovatively designed [13] . The retractor was applied for countertraction, and it allowed more precise control of the vascular pedicles and the ureters.…”

Section: Methodsmentioning

confidence: 99%

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Clinical Experience of Laparoscopic-Assisted Radical Cystectomy with Continent Ileal Reservoir

et al. 2005

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Introduction: Laparoscopic-assisted radical cystectomy with continent ileal reservoir reconstruction is a challenging procedure. We report our experience learned from a hand-assisted laparoscopic technique in our transition to a pure laparoscopic approach. Materials and Methods: Eighteen consecutive patients underwent laparoscopic-assisted radical cystectomy with continent ileal reservoir. Hand-assisted laparoscopy was used for the first 11 patients and pure laparoscopy was performed for the subsequent 7 patients in radical cystectomy. Continent ileal reservoir reconstruction was performed extracorporeally via the hand port wound or trocar extension wound. Surgical outcome was analyzed in a retrospective review of the medical records. Results: In the hand-assisted and pure laparoscopic groups, the mean operative time for cystectomy was 2.5 and 2.3 h, for continent ileal reservoir reconstruction it was 4.0 and 3.7 h, and for bilateral lymph node dissection it was 0.8 and 0.6 h, respectively. Mean intraoperative blood loss was 286 ml for the hand-assisted and 179 ml for the pure laparoscopic group. There were no major intraoperative complications nor need for conversion in any of the procedures. Bowel movement was regained in a mean of 3 days and the mean length of postoperative hospital stay was 7 days. Conclusions: The hand-assisted laparoscopic experience of radical cystectomy learned from the initial 11 patients effectively helped us in the transition to a pure laparoscopic approach. A comparable surgical outcome was found in both groups of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical Experience of Laparoscopic-Assisted Radical Cystectomy with Continent Ileal Reservoir

et al. 2005

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“…A novel method of retraction was proposed by Chiu et al [34] in the female patient using an internal bladder retractor. They report that stretching the pedicles allowed accurate manipulation of the bipolar electrocautery forceps for vascular control.…”

Section: Vascular Pedicle Controlmentioning

confidence: 99%

Laparoscopic radical cystectomy with continent urinary diversion

2005

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Laparoscopic radical cystectomy with urinary diversion, although challenging even for the skilled laparoscopist, has evolved rapidly throughout the past decade. These advances are attributable to a series of well-designed animal studies transitioned carefully to humans. Short-term data have shown that this is a feasible technique that respects the basic principles of surgical oncology. However, the possibility of decreased blood loss, improved visualization, shorter hospital stay, and less postoperative pain are balanced against technical difficulty, long operative times, and unproved long-term efficacy compared with the open gold standard. The goal of this review is to reflect the available literature with regard to surgical indications, the current technique in evolution, short-term morbidity, and oncologic outcomes.

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“…The dissection of the pelvic organs was performed with the assistance of an internal bladder retractor. 9 The uterus was mobilized first. Using the internal bladder retractor, the bladder and uterus were retracted up and laterally to stretch the ureters and the superior and inferior vascular pedicles of the bladder.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Laparoscopy-Assisted Transvaginal Total Exenteration for Locally Advanced Cervical Cancer with Bladder Invasion after Radiotherapy

Lin

Fan

Chiu³

et al. 2004

Journal of Endourology

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When invasive cervical cancer involves the urinary bladder or rectum, exenteration can be curative treatment. However, this operation, particularly by an open approach, carries significant morbidity, both physically and psychologically. Laparoscopic surgery has been documented to be a reasonable alternative to the open counterpart for a variety of pelvic operative procedures, including such advanced procedures as laparoscopy-assisted vaginal hysterectomy, total laparoscopic hysterectomy, and laparoscopy radical hysterectomy. With improving surgical technology and increasing surgical experience, exenteration is a logical extension of current laparoscopic practice. However, it raises skepticism regarding the feasibility and justification for the complicated surgery. We herein describe our experience in a patient undergoing total exenteration assisted by laparoscopic technology for advanced recurrent cervical cancer after extensive radiotherapy. Transperitoneal laparoscopic total exenteration with ureterosigmoidstomy and end-sigmoidostomy was accomplished in 6 hours. The whole specimen was removed en bloc transvaginally. The patient tolerated the procedure well. The only complication was a wound infection 50 days postoperatively that was controlled with debridement and antibiotics. No episodes of pyelonephritis occurred. After 1 year of follow-up, the patient is free of cancer by imaging studies and lives without associated morbidity of this extensive palliative operation except the care of the sigmoid colostomy.

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Internal Bladder Retractor for Laparoscopic Cystectomy in the Female Patient

Cited by 9 publications

References 5 publications

Clinical Experience of Laparoscopic-Assisted Radical Cystectomy with Continent Ileal Reservoir

Clinical Experience of Laparoscopic-Assisted Radical Cystectomy with Continent Ileal Reservoir

Laparoscopic radical cystectomy with continent urinary diversion

Laparoscopy-Assisted Transvaginal Total Exenteration for Locally Advanced Cervical Cancer with Bladder Invasion after Radiotherapy

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