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Creation of the Miami Pouch During Laparoscopic-Assisted Pelvic Exenteration: The Initial Experience
  1. Gwénaël Ferron, MD*,
  2. Timothy Yong Kuei Lim, MD, MRCOG*,
  3. Christophe Pomel, MD,
  4. Michel Soulie, MD and
  5. Denis Querleu, MD*
  1. * Institut Claudius Regaud, Department of Surgical Oncology, Toulouse;
  2. Centre Jean Perrin, Department of Surgical Oncology, Clermont-Ferrand; and
  3. CHU Toulouse, Department of Urology, Toulouse, France.
  1. Address correspondence and reprint requests to Gwénaël Ferron, MD, Institut Claudius Regaud, Comprehensive Cancer Center, Department ofSurgical Oncology, 20-24 rue du Pont Saint Pierre, F-31052 Toulouse, France. E-mail: ferron.gwenael{at}


Purpose: To describe the initial experience of laparoscopic hand-assisted Miami pouch in a group of patients undergoing pelvic exenterations for pelvic malignancies.

Materials and Methods: Thirteen female patients underwent laparoscopic-assisted pelvic exenteration in our center between September 2000 and November 2007. Six of them had the Miami pouch created for urinary diversion. The continent diversion was created extracorporeally through a right iliac fossa minilaparotomy.

Results: The mean total operative time for the laparoscopic-assisted exenteration and reconstruction was 382 minutes (range, 270-480 minutes), but specifically for the Miami pouch, it took a mean time of 106 minutes (range, 90-130 minutes). Four patients (66.7%) had postoperative urinary tract infection that resolved with antibiotics. One patient had a ureteral stenosis requiring stenting and one had a Miami pouch cutaneous fistula that required a fistulectomy. The mean follow-up was 23 months (range, 9-48 months). All patients were continent and were able to self-catheterize approximately 3 to 6 times/d.

Conclusions: It is technically feasible to incorporate the creation of the Miami continent urinary pouch through a minilaparotomy during laparoscopic pelvic exenteration without compromising the benefits of laparoscopic surgery.

  • Laparoscopy
  • Miami pouch
  • Pelvic exenteration

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