Fast and safe closing of urethra during laparoscopic radical cystectomy

Purpose: To present a simple alternative technique to close the membranous urethra during laparoscopic radical cystectomy. Patients and Methods: A series of 18 laparoscopy-assisted cystectomies were performed in our institute from November 2002 to May 2005. In order to prevent neoplastic-cell spillage, in 14 of these patients, the membranous urethra was closed with Hem-o-lok (R) clips after careful dissection of the urethra and withdrawal of the bladder catheter. Results: In all cases, one or two Hem-o-lok (R) clips were easily, safely, and quickly positioned. The remaining length of the membranous urethra was sufficient for anastomosis with the neobladder if appropriate. In follow-up (mean 14 months), no local recurrence has been recorded. Conclusion: The closing of the membranous urethra with Hem-o-lok clips during laparoscopy-assisted cystectomy is in our experience a simple, fast, safe, and effective alternative that should be considered when laparoscopic radical cystectomy is performed.