Minimally invasive surgical approaches to retrovesical structures

Background: With open surgery, it is difficult to access structures posterior to the bladder. The advent of laparoscopy provides a more direct approach to these structures. In this study, we report on our experience in treating these structures using minimally invasive techniques. Methods: Between 1998 and 2006, 11 patients underwent conventional or robotic-assisted laparoscopic (RAL) surgeries to treat various anomalies posterior to the bladder; 5/11 procedures were performed with conventional laparoscopy and the others utilized robotic-assistance. Results: There were no complications. Average EBL was 49.1 ml. Mean operative time was 233.3 min. Median total i.v. analgesic use was 0.9 mg/kg MSO₄. Median hospital stay was 2.0 days. Conclusions: Our study confirms the safety and feasibility of conventional and RAL surgery posterior to the urinary bladder. This minimally invasive procedure allows the retrovesical structures to be approach more directly, allows for excellent visualization of these structures and avoids the morbidity associated with open surgery.