Bladder cancer is a common malignancy, with radical cystectomy being the standard treatment for muscle-invasive or recurrent bladder cancer. Traditional open radical cystectomy is associated with significant morbidity, prolonged recovery, and a higher risk of complications. Laparoscopic radical cystectomy provides a minimally invasive alternative, reducing blood loss, hospital stays, and recovery time. After bladder removal, several urinary tract reconstruction options are available, including ileal conduits and continent diversions. Among these, the ileal neobladder, which allows spontaneous voiding, offers superior quality of life. Although laparoscopic surgery for this procedure is technically challenging, it combines the benefits of minimally invasive surgery with the positive outcomes of ileal neobladder formation.

A 68-year-old male patient, diagnosed with muscle-invasive bladder cancer, underwent neoadjuvant chemotherapy before proceeding with laparoscopic radical cystectomy and intracorporeal ileal neobladder. The patient was positioned in lithotomy, and a pneumatic pump was used. The peritoneum was entered, the ureters were identified and ligated with Hemoloc clips, then pelvic lymph node dissection was performed for staging. The bladder was dissected, pedicles controlled, and the urethra transected. A 50 cm segment of the distal ileum was mobilized and prepared to form the neobladder, which was constructed into a detubularized modified-Y pouch with V-loc 3-0 sutures. An intracorporeal anastomosis was created between the neobladder and urethra, bilateral ureters were reimplanted with a ureteric stent 6 Fr. After the anastomoses, the integrity of the neobladder and urinary tract was checked for leaks by instilling 200 mL of saline.

The surgery was completed without any complications. The total operative time was 600 minutes, with a blood loss of 300 mL. The drain was removed after 72 hours, and the patient was discharged on postoperative day 7. The indwelling catheter was removed on postoperative day 14 after cystography confirmed the absence leakage. Bilateral ureteric stents were removed one month postoperatively. The pathological report confirmed invasive urothelial carcinoma (pT2N0M0), free margin. At the two-month follow-up, the patient had achieved continence and maintained fair renal function.

Laparoscopic radical cystectomy with intracorporeal ileal neobladder is a safe, effective, and minimally invasive procedure for treating bladder cancer. This technique preserves continent urinary function and significantly improves the patient's quality of life. However, it requires advanced technical skills and expertise, making patient selection crucial for achieving optimal outcomes.