Laparoscopic hand-assisted Miami Pouch after pelvic exenteration in 10 steps

Background: Improvements in surgical technique of pelvic exenteration have mainly occurred in the reconstructive phase of the procedure. Quality of life seems to be improved when performing continent rather than non-continent urinary diversion [1]. Unfortunately, Miami continent urinary pouch is a surgical technique not frequently used among surgeons.

Methods: This video illustrates the creation of a laparoscopic hand-assisted Miami Pouch in 10 consecutive steps. We present the case of a patient with an isolated central pelvic recurrence of cervical cancer who underwent a laparoscopic anterior pelvic exenteration, which is not included in the film. The surgery was performed by an experienced oncological surgeon in a French comprehensive cancer center.

Results: We split the surgical technique in the 10 following steps: CONCLUSIONS: Miami Pouch is a urinary reconstructive procedure that can improve quality of life after pelvic exenteration. As it has been previously reported, this film illustrates the feasibility of laparoscopic hand-assisted Miami Pouch after laparoscopic anterior pelvic exenteration [2,3]. A step-by-step comprehensive standardization of surgical techniques shortens learning curve of training surgeons [4].