David Canes Harrison K Rhee and Ingolf Tuerk

Lahey Clinic Medical Center, Institute of Urology, Burlington, Massachusetts, U.S.A.

■ INTRODUCTION

■ INDICATIONS AND CONTRAINDICATIONS

■ A: NONCONTINENT URINARY DIVERSIONS

■ ILEAL CONDUIT

Lap-Assisted Ileal Conduit Urinary Diversion

Patient Preparation

Radical Cystectomy

Transposition of Left Ureter

Harvesting Small Bowel

Restoring Bowel Continuity

Ureteroileal Anastomoses

Creation of Ileal Stoma

Closure and Drains

Postoperative Period

■ PURE LAPAROSCOPIC ILEAL CONDUIT URINARY DIVERSION

Harvesting Small Bowel Restoring Bowel Continuity Creation of Ileal Stoma Ureteroileal Anastomoses Closure and Drains Postoperative Period Cutaneous Ureterostomy Ileovesicostomy

■ B: CONTINENT URINARY DIVERSION

■ ORTHOTOPIC NEOBLADDER Lap-Assisted Orthotopic Ileal Neobladder Patient Preparation

Radical Cystectomy Transposition of Left Ureter Harvesting Small Bowel

Restoring Bowel Continuity Creation of Neobladder Urethroneovesical Anastomosis Ureteroneovesical Anastomoses Closure and Drains Postoperative Period

PURE LAPAROSCOPIC ORTHOTOPIC ILEAL

NEOBLADDER

Harvesting Small Bowel

Restoring Bowel Continuity

Creation of Neobladder

Urethroneovesical Anastomoses

Ureteroneovesical Anastomoses

Closure and Drains

Postoperative Period

Rectosigmoid Pouch

LAPAROSCOPIC MAINZ II POUCH (SIGMA-

RECTUM POUCH)

Patient Preparation

Radical Cystectomy

Creation of Sigmoid Pouch

Ureteral Reimplantation

Closure and Drains

Postoperative Period

Continent Catheterizable Stomal Reservoirs

FUTURE DIRECTIONS

SUMMARY

REFERENCES

COMMENTARY: John P. Stein COMMENTARY: Urs E. Studer

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