Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients

Aims: This study aims to describe our surgical technique and report our preliminary experience with laparoscopic ileal or appendicovesicostomy in adult patients with neurogenic bladder caused by spinal cord injury. Subjects and Methods: From January 2014 to March 2017, seven patients were submitted...

Full description

Bibliographic Details
Main Authors: Pedro Costa, Carlos Ferreira, Damiano Bracchitta, Pierre-Émmanuel Bryckaert
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Urology Annals
Subjects:
Online Access:http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=4;spage=399;epage=404;aulast=Costa
id doaj-a2a90b1f01d246678eac19f8c73596f5
record_format Article
spelling doaj-a2a90b1f01d246678eac19f8c73596f52020-11-24T21:48:15ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342019-01-0111439940410.4103/UA.UA_167_18Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patientsPedro CostaCarlos FerreiraDamiano BracchittaPierre-Émmanuel BryckaertAims: This study aims to describe our surgical technique and report our preliminary experience with laparoscopic ileal or appendicovesicostomy in adult patients with neurogenic bladder caused by spinal cord injury. Subjects and Methods: From January 2014 to March 2017, seven patients were submitted to an appendicovesicostomy under Mitrofanoff procedure and two patients to an ileovesicostomy under Yang-Monti procedure by laparoscopy. Clinical indications were patients with a history of neurogenic bladder secondary to spinal cord pathology, with proper dexterity and willing to have a more accessible continent derivation. Surgical steps include: (1) identification and mobilization of appendix; (2) ligation of appendix' base; (3) endoloop reinforcement of proximal end; (4) silicon catheter insertion in appendix' lumen; (5) mesoappendix dissection; (6) Retzius space opening; (7) posterior bladder dissection; (8) anterior transcutaneous bladder dome fixation; (9) vertical midline detrusor incision; (10) opening of bladder mucosa; (11) excision and espatulation of appendix tip; (12) appendico vesical anastomosis; and (13) exteriorization of appendix through umbilicus and creation of catheterizable stoma. In the two patients submitted to a Yang-Monti diversion, the ileum reconfiguration and calibration was done extracorporeally. One patient had simultaneous bladder augmentation. Results: The mean follow-up was 21.5 ± 11.9 months. The mean operative time was 161 min (123–220). There was no conversion to laparotomy and no need of postoperative blood transfusion. The mean hospitalization length was 4 days. No early postoperative complication was registered. Late postoperative complications were: one surgical stoma revision, one false-passage (solved by transient catheterization), and one bladder stone (solved by endoscopic approach). All patients are continent. Conclusions: This series presents our laparoscopic technique for continent urinary diversions, showing that it is feasible and safe in adult patients with neurogenic bladder.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=4;spage=399;epage=404;aulast=CostaContinent urinary diversionlaparoscopymitrofanoffneurogenic bladderquality of life
collection DOAJ
language English
format Article
sources DOAJ
author Pedro Costa
Carlos Ferreira
Damiano Bracchitta
Pierre-Émmanuel Bryckaert
spellingShingle Pedro Costa
Carlos Ferreira
Damiano Bracchitta
Pierre-Émmanuel Bryckaert
Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
Urology Annals
Continent urinary diversion
laparoscopy
mitrofanoff
neurogenic bladder
quality of life
author_facet Pedro Costa
Carlos Ferreira
Damiano Bracchitta
Pierre-Émmanuel Bryckaert
author_sort Pedro Costa
title Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
title_short Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
title_full Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
title_fullStr Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
title_full_unstemmed Laparoscopic appendicovesicostomy and ileovesicostomy: A step-by-step technique description in neurogenic patients
title_sort laparoscopic appendicovesicostomy and ileovesicostomy: a step-by-step technique description in neurogenic patients
publisher Wolters Kluwer Medknow Publications
series Urology Annals
issn 0974-7796
0974-7834
publishDate 2019-01-01
description Aims: This study aims to describe our surgical technique and report our preliminary experience with laparoscopic ileal or appendicovesicostomy in adult patients with neurogenic bladder caused by spinal cord injury. Subjects and Methods: From January 2014 to March 2017, seven patients were submitted to an appendicovesicostomy under Mitrofanoff procedure and two patients to an ileovesicostomy under Yang-Monti procedure by laparoscopy. Clinical indications were patients with a history of neurogenic bladder secondary to spinal cord pathology, with proper dexterity and willing to have a more accessible continent derivation. Surgical steps include: (1) identification and mobilization of appendix; (2) ligation of appendix' base; (3) endoloop reinforcement of proximal end; (4) silicon catheter insertion in appendix' lumen; (5) mesoappendix dissection; (6) Retzius space opening; (7) posterior bladder dissection; (8) anterior transcutaneous bladder dome fixation; (9) vertical midline detrusor incision; (10) opening of bladder mucosa; (11) excision and espatulation of appendix tip; (12) appendico vesical anastomosis; and (13) exteriorization of appendix through umbilicus and creation of catheterizable stoma. In the two patients submitted to a Yang-Monti diversion, the ileum reconfiguration and calibration was done extracorporeally. One patient had simultaneous bladder augmentation. Results: The mean follow-up was 21.5 ± 11.9 months. The mean operative time was 161 min (123–220). There was no conversion to laparotomy and no need of postoperative blood transfusion. The mean hospitalization length was 4 days. No early postoperative complication was registered. Late postoperative complications were: one surgical stoma revision, one false-passage (solved by transient catheterization), and one bladder stone (solved by endoscopic approach). All patients are continent. Conclusions: This series presents our laparoscopic technique for continent urinary diversions, showing that it is feasible and safe in adult patients with neurogenic bladder.
topic Continent urinary diversion
laparoscopy
mitrofanoff
neurogenic bladder
quality of life
url http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=4;spage=399;epage=404;aulast=Costa
work_keys_str_mv AT pedrocosta laparoscopicappendicovesicostomyandileovesicostomyastepbysteptechniquedescriptioninneurogenicpatients
AT carlosferreira laparoscopicappendicovesicostomyandileovesicostomyastepbysteptechniquedescriptioninneurogenicpatients
AT damianobracchitta laparoscopicappendicovesicostomyandileovesicostomyastepbysteptechniquedescriptioninneurogenicpatients
AT pierreemmanuelbryckaert laparoscopicappendicovesicostomyandileovesicostomyastepbysteptechniquedescriptioninneurogenicpatients
_version_ 1725893231740190720