Videoendoscopically assisted transvaginal radical cystectomy

We describe our experience of anterior pelvic exenteration for bladder canc er in women using a combined transvaginal and laparoscopic approach. The fe asibility of videoendoscopically assisted transvaginal cystectomy was demon strated several years ago, but the indications have been greatly reduced by the spreading use of orthotopic neobladders in women. Moreover, nulliparou s patients or patients with vaginal atresia are not suitable for this techn ique, even if the specimen can also be retrieved through the minilaparotomy used for performing urinary diversion. In the last 3 years, we have perfor med only four additional cases. Nevetheless, the results are satisfactory,W e did not have any major intraoperative complication. Patients were dischar ged after 7 to 11 days (average 8.6 days) without any postoperative complic ations. The minimum survival was 13 months, and four patients are still ali ve. The operation itself is not easy and therefore can be offered only by c enters where videoendosurgery has already entered common clinical practice.