Absolutely. It can be done. Multiple surgeons have now reported that they have performed the procedure successfully. In women, the procedure technically is similar to removal of the uterus, a procedure that is commonly performed laparoscopically.
In men, the procedure is complicated by the presence of the prostate attached to the bladder. Laparoscopic removal of the prostate, although uncommon, has now gained acceptance as a valid technique for removal of the prostate in patients with prostate cancer.
Laparoscopic prostate removal takes significantly longer (4 to 8 hours) than traditional surgery (2 to 4 hours) and is more costly to the healthcare system, but it does seem to provide some benefits to patients. These benefits mainly relate to a shorter hospital stay and shorter recovery period after surgery.
Laparoscopic removal of the bladder is a similar procedure, as the prostate is removed while still attached to the bladder. The creation of an ileal conduit or neobladder adds a significant new step to the procedure. Various techniques have recently been described to perform this portion of the procedure, but it remains a challenge undertaken by only a handful of surgeons in the world.
In addition, the long-term outcomes in terms of cancer recurrence in these patients remain to be reported, although we expect it to be similar to traditional surgery.