Biocarbon ureterostomy device for urinary diversion Multicenter clinical trial

Chancellor, Michael B.; Grossman, H. Barton; Κοnnak, John W.; Diokno, Ananias C.; González, José E.; Pontes, J. Edson; Huben, Robert P.; King, Gary W.

doi:10.1016/0090-4295(89)90149-0

Cited by 3 publications

(5 citation statements)

References 6 publications

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“…Bustamante et al used vitreous carbon polymer implants to create a connection between the abdominal wall, bowel wall and implant in dogs [ 5 ]. In urostomy applications, devices made of titanium or carbon-based materials have been implanted to create continence [ 3 , 10 , 31 ]. However, most of the implanted devices were removed due to infection, fistula formation or poor ingrowth and function.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory bowel disease, colorectal and gynaecological cancer, neurological bladder disorders and bladder cancer sometimes require excisional surgery with the creation of an abdominal stoma. Many attempts have been made over the years to overcome the problems of a conventional stoma by creating continent ileo-or urostomies, complex constructions often associated with considerable morbidity and failure rates [1][2][3][4][5]. The continent ileostomy, first described by Dr. Nils Kock in 1969, gained popularity in the 1970s and early 1980s, and the technique was also used for urinary diversion [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Achieving stomal continence with an ileal pouch and a percutaneous implant

Johansson

Hultén

Jonsson

et al. 2022

J Mater Sci: Mater Med

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In this study, a soft-tissue-anchored, percutaneous port used as a mechanical continence-preserving valve in reservoir ileo- and urostomies was functionally and morphologically evaluated in eight dogs. During follow-up, the skin failed to attach to the implant, but the intestine inside the stoma port appeared to be attached to the mesh. After reaching adequate reservoir volume, the urostomies were rendered continent by attaching a lid to the implant. The experiments were ended at different time intervals due to implant-related adverse events. In only one case did the histological evaluation reveal integration at both the implant-intestine and implant-skin interfaces, with a low degree of inflammation and the absence of bacterial colonisation. In the remaining cases, integration was not obtained and instead mucosal downgrowth and biofilm formation were observed. The skin-implant junction was characterised by the absence of direct contact between the epidermis and the implant. Varying degrees of epidermal downgrowth, granulation tissue formation, inflammatory cell infiltration and bacterial growth and biofilm formation were prominent findings. In contrast, the subcutaneously located anchor part of the titanium port was well integrated and encapsulated by fibrous tissue. These results demonstrate the opportunity to achieve integration between a soft-tissue-anchored titanium port, skin and intestine. However, predictable long-term function could not be achieved in these animal models due to implant- and non-implant-related adverse events. Unless barriers at both the implant-skin and implant-intestine junctions are created, epidermal and mucosal downward migration and biofilm formation will jeopardise implant performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Achieving stomal continence with an ileal pouch and a percutaneous implant

Johansson

Hultén

Jonsson

et al. 2022

J Mater Sci: Mater Med

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“…Bustamante et al used vitreous carbon polymer implants to create a connection between the abdominal wall, bowel wall and the implant in dogs 24. In urostomy applications, devices made of titanium or carbon‐base materials have been implanted to create continence 25–27. However, most of the implanted devices were removed due to infection, fistula, or poor function and ingrowth.…”

Section: Discussionmentioning

confidence: 99%

“…24 In urostomy applications, devices made of titanium or carbon-base materials have been implanted to create continence. [25][26][27] However, most of the implanted devices were removed due to infection, fistula, or poor function and ingrowth. Jonsson et al used titanium rings to repair and stabilize dysfunctioning nipple valves in continent urostomies.…”

Section: Discussionmentioning

confidence: 99%

Integration between a percutaneous implant and the porcine small bowel

Johansson¹,

Thomsen²,

Hultén³

et al. 2011

J Biomed Mater Res

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Inflammatory bowel diseases, cancer or trauma may require removal of all or part of the intestines, leaving the patient with a need to wear external stoma appliances for collection of bowel contents. By connecting the small bowel to a percutaneous port, equipped with a sealing lid, a fully continent and leak proof stoma can be created without a need for permanently wearing stoma appliance. The prerequisites for a connection between a permanent, transabdominal implant and a visceral organ are largely unexplored. Stoma ports made of titanium were implanted in the abdominal wall of domestic pigs and a branch of distal ileum was inserted through the ports. After being followed for 1-3 weeks, the ports were removed and subjected to histological evaluation to study the influence of their shape, structure, and position on the tissue response. Particular focus was attended to the attachment of the ileal serosal surface to the implants inner structure consisting of a titanium mesh. Macroscopic examination revealed fistulas and formation of abscesses in 4 of 11 the retrieved implants. Histological examination revealed regenerated and well-vascularized collagenous tissue around the mesh structure inside the implant. The integration was complete or partial for 10 of 11 ports. Despite various degrees of inflammation and tissue ingrowth, it was demonstrated for the first time that the serosal surface of ileum was firmly attached to the internal structure of the implant. These experiments provide a basis for optimization of the implant and surgical procedure before long-term functional animal experiments.

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“…The param- sionary conduits are a logical alternative. With the TUUC described in 1958 by Obrant [ 1 ], both the surgical compli cations and the results of diversionary conduits are less at least in the short and medium term [11][12][13][14], However, their main problem (stoma stenosis) can be definitively avoided neither with the numerous ureteral and/or cuta neous grafts, nor with an implantable plastic prosthesis [15][16][17], Whenever necessary, only one of the two ureters may be intubated (e.g. with a double-J catheter), but the other may be obstructed by this.…”

Section: Resultsmentioning

confidence: 99%

Transureteropyeloureterocutaneostomy

Lent¹

1993

Eur Urol

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Despite the most recently available means of creating transitory and palliative diversionary conduits via percutaneous nephrostomy and avoiding definitive conduits by means of intestinal bladder substitutes, alternative supravesical conduits remain topical. This is the case on the one hand when nephrostomy is not desired or tolerated and on the other hand when the general and local prerequisites for vesical bladder replacement are absent. For these cases, transureteropyeloureterocutaneostomy is available as a new modification. In this method, both kidneys are drained with a single cutaneous stoma without intestinal connection via an intubated ureter (as a ureteral conduit). The results of 3 years of experience in 23 patients are communicated.

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Biocarbon ureterostomy device for urinary diversion Multicenter clinical trial

Cited by 3 publications

References 6 publications

Achieving stomal continence with an ileal pouch and a percutaneous implant

Achieving stomal continence with an ileal pouch and a percutaneous implant

Integration between a percutaneous implant and the porcine small bowel

Transureteropyeloureterocutaneostomy

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