LAPAROSCOPICALLY ASSISTED TRANSVAGINAL RADICAL CYSTECTOMY

Herein we describe 5 cases of anterior pelvic exenteration in females through a combined transvaginal and laparoscopic approach for bladder cancer. In 4 cases hysterectomy and bilateral ovariectomy were perform ed. As far as urinary diversion is concerned, a bilateral cutaneous ur eterostomy was performed in the 1st case, and in the remaining 4 an il eal conduit was accomplished through a minilaparotomy at the stoma sit e. The surgical specimen was withdrawn 'en bloc' transvaginally in all cases except 1, in whom vaginal atrophy forced us to perform a midlin e minilaparotomy. Total operative time ranged between 6 and 9 h, and 4 patients were discharged after 7-11 days with no complications. One p atient was discharged only after 18 days due to obesity and diabetic p roblems. A larger series is needed to confirm the advantages of the co mbined transvaginal and videolaparoscopic approach for anterior pelvic exenteration as compared to the conventional procedure, with special regard given to the oncological outcome. Our initial experience is sur ely encouraging.