Title
Laparoscopic Augmentation Enterocystoplasty Through a Single Trocar
Date Issued
01 June 2009
Access level
metadata only access
Resource Type
journal article
Author(s)
Noguera R.J.S.
Carmona O.
De Andrade R.J.
Luis S.
Cuomo B.
Manrique J.
Gill I.S.
Desai M.M.
Instituto Médico La Floresta
Publisher(s)
Elsevier
Abstract
Objectives: To report on the initial case and surgical technique of laparoendoscopic, single-site, subtotal cystectomy and augmentation enterocystoplasty performed through a single multichannel transumbilical port in a patient with neurogenic bladder. Methods: Laparoendoscopic, single-site, subtotal cystectomy and augmentation enterocystoplasty was performed in a 20-year-old woman with neurogenic bladder secondary to congenital sacral lipoma that had been operated on at 2 years of age. The patient had a long history of urinary incontinence and frequent and urgent urination. The imaging and urodynamic studies revealed a 100-mL bladder capacity with thickened walls, countless diverticula, and low compliance. The procedure was performed exclusively using a novel multichannel access port. Additional instruments included the 5-mm video laparoscope, SonoSurge, and flexible scissors. Subtotal cystectomy was initially performed by resecting 70% of the bladder. The ileal loop was exteriorized through the single port by detaching the valve, and the ileal pouch and bowel continuity were restored extracorporeally. The vesicoileal anastomosis was performed laparoscopically. Results: The operating time was 300 minutes, and the blood loss was <100 mL. No intraoperative or postoperative complications developed. The hospital stay was 6 days. The drain and Foley catheter were removed at 7 and 21 days postoperatively, respectively. Postoperative cystography confirmed a watertight anastomosis and increased bladder capacity. At last follow-up, the patient was performing intermittent self-catheterization to complete emptying. Conclusions: Our initial experience with laparoendoscopic, single-site, subtotal cystectomy and enterocystoplasty through a single port was encouraging. The use of the larger diameter port significantly facilitated extracorporeal bowel reconstruction and can be used for various minimally invasive surgical procedures. © 2009 Elsevier Inc. All rights reserved.
Start page
1371
End page
1374
Volume
73
Issue
6
Language
English
OCDE Knowledge area
Neurología clínica
Scopus EID
2-s2.0-67349098592
PubMed ID
Source
Urology
ISSN of the container
15279995
Sources of information: Directorio de Producción Científica Scopus