Technique and results in total laparoscopic radical cystectomy with sigmoidorectal pouch (Mainz pouch II) - an initial experience

We used laparoscopic radical cystectomy (LRC) with urinary diversion for muscle-invasive bladder cancer. A series of total LRC is presented with Mainz pouch II after we had gained experience of nearly 200 open radical cystectomy and 23 LRC. Since from October 2010 to April 2012, we performed totally LRC in 5 patients with muscle-invasive bladder cancer with Mainz pouch II as a urinary diversion. We analyzed age, pathological staging, continence, operative time, blood loss, blood transfusion volume, and complications. The mean age of the patients was 58.8 +/- 7.6 years (range, 49-69 years), and the follow-up time was 15.4 +/- 4.72 months. The mean operative time was 577.0 +/- 126.4 min for total LRC, with a mean blood loss of 280.0 +/- 130.38 ml and a mean hospital stay of 29.4 +/- 9.2 days. Blood transfusion was required in two cases, and imme-diate and late complications were observed in 2 cases. In conclusion, total LRC with urinary diversion is feasible for the management of muscle-invasive bladder cancer, by experienced surgeons, and despite the high level of difficulty of these procedures.