Laparoscopic Partial Cystectomy Guided by Real-Time Cystoscopic Visualization

Abstract Introduction: Laparoscopic partial cystectomy is limited to solitary tumors in the bladder (bladder endometriosis, pheochromocytoma, leiomyoma, squamous cell, adenocarcinoma, and transitional cell carcinoma) where a sufficient margin is obtainable. The tumor should be distant both from the bladder neck and trigone, as well to allow adequate resected margin (1–2 cm). Materials and Methods: To demonstrate this technique, we present a case of a 69-year-old diabetes mellitus/hypertension/coronary artery disease male patient with a history of painless gross hematuria since 1 month, on evaluation found to have lobulated a 4 × 3 cm bladder mass lesion on the anterosuperior bladder wall. He initially underwent cystoscopy and biopsy, which showed well-differentiated adenocarcinoma infiltrating the lamina propria and muscularis propria. Hence, he was planned for laparoscopic partial cystectomy. The surgery was performed in a steep Trendelenburg position with standard four ports (two 12 mm and two 5 mm) bei...