with a Boari flap or bladder advancement flap.

via a traditional laparoscopic or robotic approach.

with a cross-trigonal approach.

with all of the above.

with a psoas hitch.

The contralateral vesical pedicle may be transected if necessary.

The bladder flap should be slightly shorter than anticipated because bladder tissue can be easily stretched.

A tension-free anastomosis is important.

Typically, a refluxing ureteral anastomosis is created.

An adequate-size bladder must be present (>300╯mL).

interposition of a flap of peritoneum or omentum.

wide excision of the fibrous and scar tissue.

good exposure of the fistulous tract.

tension-free repair of the vagina and bladder.

adequate drainage.

inflammatory bowel disease.

noncompliance.

diverticulosis.

renal failure.

ulcerative colitis.

The mesenteric pedicle of the selected bowel segment is wide and broad based.

The mesenteric window is closed.

Reestablishment of bowel continuity is a critical step of the operation and may be performed extracorporeally for added security, if necessary.

Bowel-to-bladder anastomosis is optimally performed with interrupted serosa-to-serosa sutures.

Subtotal cystectomy may be necessary.

history of multiple tumors or carcinoma in situ (CIS).

solitary invasive bladder tumor located at a distance from the ureteric orifices.

good bladder capacity.

tumor at the bladder dome.

tumor in the bladder diverticulum.

Five-year survival rates range from 80% to 90%.

Thirty to 40 percent of patients with bladder cancer are candidates for a partial cystectomy.

All of the above

Laparoscopic partial cystectomy is now an established procedure.

None of the above

Previous open pelvic surgery

Multiple bladder tumors

T4 disease

Moderate obesity

Nonbulky, invasive bladder cancer

uterus- and vagina-sparing radical cystectomy.

Indiana pouch, constructed intracorporeally.

orthotopic neobladder.

anterior pelvic exenteration in the female.

extended pelvic lymph node dissection.

obturator nerve (posterior).

bladder (medial).

aortic bifurcation area (proximal).

Cooper ligament.

external iliac artery (lateral).

International collaboration

All of the above

Elimination of bowel through use of novel bladder substitutes

Careful, prospective, long-term evaluation of oncologic and functional outcomes

Intracorporeal performance of radical cystectomy and extracorporeal performance of bowel work