Laparoscopic orthotopic ileal neobladder

Journal of Endourology
Jihad H KaoukG T Sung

Abstract

Orthotopic ileal neobladder is currently the preferred continent urinary diversion in suitable patients undergoing radical cystectomy for muscle-invasive bladder cancer. To our knowledge, presented herein is the initial report of laparoscopic orthotopic ileal neobladder following cystectomy that was performed completely intracorporeally in a porcine model. The laparoscopic technique was developed in seven pigs. Subsequently, a long-term survival study was performed in 12 consecutive animals. Laparoscopic cystectomy was performed, preserving the urethral sphincter. An ileal segment of 35 cm (first three animals), 45 cm (next four), or 55 cm (final five animals) with adequate mesentery was isolated; and ileal continuity was restored intracorporeally by a stapled anastomosis. Ileal detubularization for construction of an ileal neobladder, urethroileal anastomosis, and bilateral stented ileoureteral anastomoses to a tubular Studer limb extension were all created completely intracorporeally using only laparoscopic free-hand suturing and knot-tying. Biochemical data (preoperative and serial postoperative hemoglobin, renal panel, blood gases), radiologic studies (intravenous urogram, retrograde pouchgram), functional measures (neoblad...Continue Reading

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Citations

Feb 8, 2007·Surgical Endoscopy·M C SighinolfiG Bianchi
Feb 19, 2005·Current Urology Reports·David CanesIngolf Tuerk
Feb 19, 2005·Current Urology Reports·Osamu UkimuraInderbir S Gill
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Aug 9, 2001·Current Opinion in Urology·B Guillonneau

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