Background To evaluate the safety and feasibility of a novel modified laparoscopic radical cystectomy (MLRC) for female bladder cancer patients and to introduce a stepwise description of the modified procedure. Methods This retrospective cohort study, conducted from June 2021 to June 2024, included 45 female patients who underwent operative treatment. Perioperative data were compared between the MLRC group (25 patients) and the traditional laparoscopic radical cystectomy (TLRC) group (20 patients). Statistical significance was set at p < 0.05. The MLRC technique was characterized by delayed ureteral clamping to preserve renal function, dissection of the peritoneal reflection was avoided, en bloc resection of the bladder and uterus was performed without dissecting the intervening plane, placing a gauze‐packed glove in the vagina for uterine positioning instead of a uterine manipulator, transvaginal specimen extraction, and final pelvic lymph node dissection after specimen removal. Results All operations were completed without conversion to open surgery. The MLRC group had significantly shorter ureteral clamping times ( p < 0.001), lower serum potassium concentrations at 2 h postoperation ( p < 0.001), less estimated blood loss ( p < 0.001), reduced operative time ( p < 0.001), shorter pelvic lymph node dissection (PLND) times ( p < 0.001), faster time to first postoperative defecation ( p < 0.01), fewer complications ( p < 0.05) and shorter postoperative hospital stay ( p < 0.001). There were no significant differences between the groups in urinary reconstruction, overall survival, local recurrence, distant metastasis, or American Society of Anesthesiologists (ASA) scores. Conclusion MLRC is a safe and feasible approach that offers improved perioperative outcomes compared to traditional laparoscopic procedures.
Chen et al. (Thu,) studied this question.