Robot-assisted laparoscopic ileal bladder augmentation: defining techniques and potential pitfalls

Journal of Endourology
Carlo C PasserottiCraig A Peters

Abstract

Laparoscopic bladder augmentation has been limited because of the extensive suturing required. The use of robot-assisted laparoscopic (RAL) procedures may circumvent this limitation and allow more efficient suturing. The purpose of the study is to define the techniques and the potential pitfalls in performing RAL bladder augmentation in an animal model. Ten swine underwent RAL bladder augmentation using 20 cm of ileum. In five animals, the bowel anastomosis was performed intracorporeally. In the others, the bowel ends were externalized through one of the ports, and a free-hand bowel anastomosis was performed. The operative time was recorded. The anastomoses were evaluated for patency and leakage. The mean procedure time was 6 hours 44 minutes (range 5 hours 50 min-8 hours 5 min) with a rapid learning curve. We identified minor technical modifications that were helpful, such as placement of "hitch stitches," irrigation of the isolated bowel loop extracorporeally, and leaving the bladder wall attachment intact to maintain bladder suspension. Leakage at the bowel-bowel anastomosis occurred in one animal with use of a stapling technique. Because this could be a potentially fatal complication, we altered our technique to perform the...Continue Reading

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Citations

Oct 9, 2013·Nature Reviews. Urology·Luís F Sávio, Hiep T Nguyen
Nov 6, 2010·Journal of Endourology·Justin J Gould, John T Stoffel
Mar 7, 2014·Case Reports in Urology·Maryellen T DolatAdam P Klausner
May 27, 2014·Journal of Robotic Surgery·MaryEllen T DolatLance J Hampton
Jan 2, 2013·The Journal of Urology·Joao A B A BarbosaHiep T Nguyen
Aug 18, 2009·The Journal of Urology·Nivaldo da Silva LavouraDaniel Silva
Mar 21, 2012·BJU International·Marcelo A OrvietoMohan S Gundeti
Jul 21, 2009·Urology·Alex J VanniJohn T Stoffel
Jun 10, 2010·Current Opinion in Urology·Jose A S da Cruz, Carlo C Passerotti
Nov 22, 2012·Current Opinion in Urology·Lorenzo F M Trevisani, Hiep T Nguyen

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