Suprapubic transvesical laparoendoscopic single-port bladder diverticulectomy: points of technique with medium-term surgical outcomes.

Background And Purpose: Various minimally invasive techniques have been developed for bladder diverticulectomy. One of the newest is transvesical laparoendoscopic single-site (T-LESS) surgery. In this article, we present points of technique with initial clinical results after a minimum of 7 months of follow-up. The aim of the study was to assess our first series of patients who underwent T-LESS surgery for transvesical excision of symptomatic bladder diverticula.

Patients And Methods: From March 2011 to February 2012, we successfully operated on five men aged 61 to 76 years (mean 66 years) for symptomatic (infections, residual of urine, neoplasm) bladder diverticula, with the use of the T-LESS approach. The procedures were performed using single-port TriPort+, standard laparoscopic instruments, and V-loc suture. All patients underwent follow-up of 6 weeks after surgery and every 3 months thereafter. The follow-up included urine tests, ultrasonography, and cystoscopy when needed.

Results: The average operative time was 122 minutes (range 80-175 min), and the blood loss was minimal. Patients were discharged on the third (range 2-4 day) postoperative day with no intra- or postoperative complications. The average 14-month follow-up (range 7-19 mos) confirmed good operative results in all cases. An insignificant small recurrent diverticulum was observed in one patient. The patients did not need transurethral resection of the prostate or reoperation.

Conclusions: We consider this technique to be a feasible and safe procedure, and a valuable treatment option for bladder diverticulectomy.