A Novel Neobladder-Urethral Drag-and-Bond Anastomosis Technique During Laparoscopic Radical Cystectomy for Ileal Orthotopic Neobladder: Surgical Technique and Initial Research

Yu, Zhaojun; Huang, Jiehui; Deng, Hui; Zeng, Zhipeng; Deng, Leihong; Xu, Xiangda; Chao, Haichao; Zeng, Tao

doi:10.2147/cmar.s288673

Cited by 4 publications

(3 citation statements)

References 17 publications

(18 reference statements)

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“…When using the described modification, there is a significant reduction in the required time of surgery and the absence of severe complications after the intervention, but these changes have not been popularized in urology due to the lack of clinical studies. From January 2014 to December 2018, on the premises of Nanchang University, Yu et al (20) conducted a study to compare the performance of the vesicourethral anastomosis laparoscopically and the performance of the same anastomosis, but with tension and ligation and using only one Foley catheter. In conclusion, vesicourethral anastomosis with tension and ligation offers several advantages.…”

Section: Discussionmentioning

confidence: 99%

Immediate Results of Orthotopic Intracorporeal Ileoneocystoplasty in the Modification of the Clinic

Shamraieva

2023

Gac Méd Caracas

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Relevance: Bladder cancer remains an urgent problem in the field of oncological urology, which requires great attention and additional clinical trials. Based on information from the World Health Organization, bladder cancer ranks 10th in the overall prevalence of all cancer pathologies worldwide in 2022 with an upward trend. Objective: This study aimed to evaluate the improved reconstructive stage of radical cystectomy for neocyst formation in patients with muscle-invasive bladder cancer. Results: A study involving 9 patients undergoing orthotopic ileoneocystoplasty revealed that all maintained normal urinary function. The procedure showed promise in mitigating its radical nature through positive changes, aided by advanced suture techniques that reduced surgical duration and minimized tissue traumatism and scarring. Additionally, its adaptability to various Radical Cystectomy approaches suggests its potential as a versatile option in urological surgery.

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Section: Discussionmentioning

confidence: 99%

Immediate Results of Orthotopic Intracorporeal Ileoneocystoplasty in the Modification of the Clinic

Shamraieva

2023

Gac Méd Caracas

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“…З січня 2014 року по грудень 2018 року на базі Наньчанського університету урологами Чжао Цзюнь та Джианбяо Хуан було проведено дослідження, метою якого було порівняння виконання міхурово-уретрального анастомозу лапароскопічно та анастомозу, але з натягом та перев'язуванням з використанням лише одного катетера Фолея. У висновку отримали результат, що підтверджував переваги везикоуретрального анастомозу з натягом і перев'язуванням, адже для хірургів він був простішим в освоєнні, легшим і зручнішим, а також час оперативного втручання був меншим, ніж при лапароскопічному варіанті [16].…”

Section: результати дослідження та їх обговоренняunclassified

“…Відкриттям у галузі урології була проведена професором Урсом Штудером методика формування неоцисту -артифіційного ортотопічного сечового міхура [2,16], що формується із відділів тонкої кишки і напряму з'єднується з уретрою. Але вагомим недоліком даного втручання були труднощі у підведенні лівого сечовода під сигмоподібну брижу для створення уретероентерального анастомозу.…”

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Ileoneocystoplasty After Radical Cystectomy – Modification of the Method and Immediate Results

Vozianon,

Shamraieva

2024

ЗЧ

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The objective: is to evaluate the effectiveness of the treatment of muscle-invasive bladder cancer (MIBC) by creating an artificial reservoir for the derivation of urine from segments of the small intestine of patients and to study urination and other functions of the urinary system in the postoperative period. Material and methods. During 2019-2020, the SI «Academician O.F. Vozianov Institute of Urology National Academy of Sciences of Ukraine» conducted examinations and treatments on nine patients diagnosed with MIBC at clinical stages T2aN0M0–T3bN0M0. All patients underwent laparoscopic cystectomy and lymphadenectomy, while a third of them underwent open bladder resection at other medical facilities. Among these, three patients received intracorporeal ileoneocystoplasty, whereas in six patients, the procedure involved a change in access from a median laparotomy. The implemented method of orthotopic ileoneocystoplasty during radical cystectomy involves creating an orthotopic artificial bladder from a previously resected segment of the ileum and anastomosing it with the proximal part of the urethra and the distal segments of the ureters. Notably, this method introduces several innovations: firstly, it allows for instrumental intestinal suturing in cases of endoscopic variants of radical cystoprostatectomy, and reduces the necessary length of the ileo-intestinal fragment to 50 cm. Secondly, it involves complete detubularization of the intestine fragment, asymmetrically during its middle 5 cm to form a cervical flap, and symmetrically along the contramesenteric edge for the remaining length. Thirdly, the medial edges of the right and left intestinal segments are initially fixed to the upper edge of the middle segment. Fourthly, after creating the eye of the neck of the future reservoir, the upper and middle thirds of the lateral edge of the right and left intestinal segments are fastened together. Fifthly, the original neck of the intestinal bladder is formed by performing vertical incisions of the pre-created eye of the neck of the reservoir at 12 and 6 o’clock to expand its diameter to 1.0–1.5 cm, followed by eversion and tubularization of the formed semicircles on the urethral catheters using 3–5 nodal sutures and a neck duplication maneuver with two nodal, superimposed parallel to the axis of the neck, sero-muscular sutures with a step between injection and needle puncture of 0.3–0.5 cm. Sixth, after forming the vesico-urethral anastomosis, the free edge of the cervical flap and the lower thirds of the lateral edge of the right and left intestinal segments are sutured, the adoral nd aboral intestinal openings are sealed, a cystostomy drainage is installed through the latter, and a reversible peritonization maneuver is performed. Results. According to the type of intervention, patients were divided into 2 groups: 1 group of open ileoneocystoplasty – 6 patients, 2 group of intracorporeal ileoneocystoplasty – 3 patients. According to the results of the operation, the average volume of the artificial reservoir immediately after the operation was: in group 1 – 180 ml ± 23 ml, in group 2 160 ml ± 50 ml. After 6 months, this volume increased and was 420 ± 68 ml in group 1, 380 ± 50 ml in group 2, which allowed patients to urinate 6-8 times a day and 2-3 times a night in some cases. The postoperative bed-day in group 2 was shorter on average by 7 days (7.2 ± 1.5 vs. 14.2 ± 4.2). In this study, there were no registered cases of leakage of the vesico-urethral anastomosis or its stenosis. Conclusions. Application of the proposed method of orthotopic ilioneocystoplasty during radical cystectomy will allow: – to reduce the total time of the operation in connection with the use of modern methods of intestinal suture provided for in its framework; – to compensate for the possible tension of the vesico-urethral anastomosis, which will lead to a decrease in the frequency and intensity of such postoperative complications and negative consequences as: leakage of the vesico-urethral anastomosis or its stenosis, as well as urinary incontinence at night; – thanks to the original maneuver of forming the neck of the ileal reservoir, reduce the hypermobility of the reconstructed bladder-urethral segment; – reduce the likelihood of metabolic disorders in the postoperative period due to the reduction of the length of the ileal segment removed from the patient; – to unify the technology of orthotopic ilioneocystoplasty within the framework of various approaches to performing radical cystectomy, among them: traditional «open», laparoscopic or robot-assisted.

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The clinical study of urinary flow parameters after drag-and-bond anastomosis for ileal orthotopic neobladder reconstruction

Luo,

Xu,

Lin

et al. 2024

Int Urol Nephrol

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A Novel Neobladder-Urethral Drag-and-Bond Anastomosis Technique During Laparoscopic Radical Cystectomy for Ileal Orthotopic Neobladder: Surgical Technique and Initial Research

Cited by 4 publications

References 17 publications

Immediate Results of Orthotopic Intracorporeal Ileoneocystoplasty in the Modification of the Clinic

Immediate Results of Orthotopic Intracorporeal Ileoneocystoplasty in the Modification of the Clinic

Ileoneocystoplasty After Radical Cystectomy – Modification of the Method and Immediate Results

The clinical study of urinary flow parameters after drag-and-bond anastomosis for ileal orthotopic neobladder reconstruction

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