The Feasibility, Technique, and Medium-Term Follow-Up of Laparoscopic Transvesical Diverticulectomy.

ABSTRACT

BACKGROUND: To present our experience and results with the transvesical laparoscopic diverticulectomy, developed by Pansadoro et al. [BJU Int. 2009;103(3)412-24], as treatment of symptomatic bladder diverticula, with a medium-term follow-up. METHODS: Between June 2010 and July 2018, we successfully operated 15 patients (13 male/2 female), aged 32-85 years (mean age 61 years) in 2 centers in Austria, using the aforementioned technique. RESULTS: The median operative time was 297 min (range 83-488 min), and the blood loss was minimal. The median diameter of the diverticula was 94 mm (range 40-110 mm). The transurethral catheter was removed in most patients on day 7 (range 1-26 days), and cystography was performed before catheter removal. Patients were discharged on the ninth postoperative day (range 4-18 days). One case had a Clavien-Dindo grade IIIb complication (ureter injury), and 2 cases had a grade IIIa complication (nephrostomy drainage). After a median follow-up of 19 months, no recurrences were observed. CONCLUSION: The laparoscopic, transvesical diverticulectomy is a feasible and valuable procedure with good outcomes. To avoid complications, the ureter needs to be spared meticulously.