Laparoscopic radical cystectomy in patients with bladder cancer: A modified technique with reduced morbidity - A comparative study.

Background: We describe a modified technique for laparoscopic radical cystectomy (LRC) utilizing a mini-laparotomy incision for conduit formation and compare outcomes with the conventional technique. Materials and methods: This retrospective single-centre study included patients with bladder cancer undergoing LRC at a tertiary care centre between September 2019 and December 2024. Patients were divided into conventional LRC (CLRC) and modified LRC (MLRC) groups. Statistical analysis was performed using chi-square and Student’s t -test ( p < 0.05 considered significant). Results: A total of 228 patients were included (CLRC: 58; MLRC: 170). Operative time was significantly longer in MLRC (253 vs 246 min, p = 0.0018). However, mean blood loss (370 vs 543 ml, p < 0.001), incision size (8.5 vs 14.5 cm, p < 0.001), time to oral intake (3.5 vs 3.8 days, p < 0.001), and hospital stay (10.8 vs 11.6 days, p < 0.001) were significantly reduced. Two early postoperative deaths (Clavien–Dindo Grade V) occurred in CLRC. At 2-year follow-up, recurrence (7.1% vs 10.3%) and mortality (1.2% vs 5.2%) were comparable between groups. Conclusion: The modified technique is feasible and reproducible. Despite longer operative time, it significantly reduces postoperative morbidity with comparable short-term oncological outcomes.