Hand Assisted Laparoscopic Radical Cystectomy

The first case report of hand-assisted laparoscopic radical cystectomy with ileal conduit was described by Peterson et al. in 2002 (23). Operative time was seven hours with 750 mL of blood loss. McGinnis et al. described the first series of seven patients undergoing handassisted laparoscopic radical cystectomy and ileal conduit. Mean operative time was 7.6 hours, blood loss was 420 mL, and hospital stay was 4.6 days (24). In 2004, Taylor et al. documented nonrandomized comparison between hand-assisted laparoscopic radical cystectomy and open cystectomy in eight cases each (25).

The author reported significant difference was observed only in the mean postoperative parenteral analgesia administration; hand-assisted, 31 mg versus open, 149 mg (p = 0.01); however, no statistical differences in others, including (i) operative time; handassisted, 403 minutes versus open, 420 minutes (p = 0.7), (ii) blood loss; hand-assisted, 637 mL versus open, 957 mL (p = 0.2), (iii) hospital stay; hand-assisted, 6.4 days versus open, 9.8 days (p = 0.06), (iv) regular diet; hand-assisted, 4.5 days versus 7.9 days (p = 0.05).

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