Minimally invasive surgery for bladder cancer and urinary diversion is increasingly gaining acceptance at select institutions across the world.

Long-term oncologic outcomes of laparoscopic radical cystectomy are limited; however, the currently available perioperative and short-term oncologic outcomes are encouraging. Laparoscopic radical cystectomy should include extended pelvic lymphadenectomy mirroring the template of open surgery.

Laparoscopic approach contributes to decreased postoperative pain and quicker recovery with similar complication rate to open surgery.

Reconstructive creation of the bowel reservoir and ureterointestinal anastomoses are preferably performed extracorporeally through a minilaparotomy, and then, in patients undergoing orthotopic reconstruction, the urethroenteric anastomosis is completed intracorporeally. An international registry of laparoscopic radical cystectomy has been established by the author to facilitate development of this emerging field in a cohesive manner to optimize operative techniques, establishing standardized critical care postoperative pathways, and prospectively collecting oncologic, functional, and quality-of-life outcomes data.

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