Under general anesthesia, the abdomen is insufflated with a 10mm trocar in the ombilical area, 4 other trocars are placed in the iliac fossas. The optic is controlled with a vocal command robot.

  When indicated , a lymph node dissection is performed.

  The bladder is dissected in the pelvis and separated from the prostate.

  A frozen section of the prostatic urethra and prostatic tissue is done, in order to eliminate a risk of prostate cancer.

  After having removed the bladder through a medial abdominal incision, we perform a Z neobladder. This new bladder is sutured to the prostate capsula. The two ureters are reimplanted in the neo bladder.

  The all cost of laparoscopic radical cystectomy (fees, drugs, imaging and laboratory tests) is 20.000 euros.

Our limit of dissection sparing the prostate capsule and the seminal vesicles.	The neobladder is made with 40 cm of ileum reconstructed in Z shape. The ileal bladder is sutured to the prostate capsula. The 2 ureters (U1) are implanted in the neo-bladder.
Reconstruction of the neobladder A running suture of Vicryl 3/0 with a right needle is performed leaving on each extremity 3 cm of non detubularized ileum in which both ureters are directly reimplanted.