Technical improvements to reduce intraoperative bleeding in laparoscopic radical cystectomy:168 cases report
Ou Xuanwei
Liu Jianhe
Zhao Yanliang
Zhou Wenbo
Wang Guang
Li Pei
Shi Xin
Li Jiongming
Abstract：Objective:To explore the technology and method to effectively reduce intraoperative bleeding in lap-aroscopic radical cystectomy(LRC).Method:168 male patients with bladder neoplasms underwent LRC admitted in our hospital from 2015 to 2023were retrospectively analysed.Methods for improving intraoperative bleeding includ-ed the following that block the bilateral umbilical arteries to reduce the blood supply to the bladder and prostatebefore removing the bladder;resection the obturator lymph nodes along the anatomical level of the pelvic wall and anterior sacrum,and free the entire obturator lymphatic fat tissue to the lateral wall of bladder to expose and cut off the lym-phatic tissue and the vascular communication branches between the pelvic wall and the sacrum;dissect the bladder lat-eral ligament and prostatic vascular pedicle carefully,then block it by Hem-o-lok and cut it off;free the dorsal vascu-lar complex(DVC)and expose the bilateral wall of it clearly,suture and cut off DVC.Results:Operative time of 168 patients was 120-190min,average 155min.Intraoperative bleeding was 20-300 ml,average 86 ml,and the rate of intraoperative blood transfusion was 4.17%.There were no serious intraoperative complications,conversion to open surgery or postoperative secondary bleeding.Conclusion:Intraoperative bleeding and the occurrence of serious complications can be effectively reduced by improving the methods and techniques of intraoperative bleeding control-ling LRC.
Keywords：bladder neoplasmslaparoscopecystectomyhemorrhage
Publication Date：2024-02-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 45-48 )