V11-10: Single port surgery (LESS) for bladder diverticulum and incidental discovery of superficial bladder carcinoma
VideoIntroductions and Objectives
This video reports the case of a man suffering from a 200ml bladder diverticulum. During the laparoscopic procedure we have discovered urothelial bladder tumours.
This 62 years old man consulted for dysuria due to an urethral stricture. An endoscopic procedure has been performed and no tumour has been detected. The dysuria has been successfully treated but the patient felt uncomfortable because of this diverticulum and a 300ml post void residual. We have decided to schedule the resection of this diverticulum. We had experience of single port procedures and we have decided to use this access for this surgery. The major steps of this procedure have been described in this video. Incidental discovery of superficial bladder tumours has been highlighted. These tumours have been resected or destroyed laparoscopically without any additional trocar.
Histology has reported superficial Ta urothelial tumours but no tumour has been found inside the diverticulum. Two months later the cystoscopy has revealed recurrences and trans urethral resection of bladder has been performed and is shown in this video. Histology has reported the same superficial tumour. Laparoscopic procedures does not seem to be associated with a higher risk of bladder tumour dissemination even if very few data are available.
We have decided to follow this patient with biannual cystoscopy and imaging (CT).