Robot-Assisted Laparoscopic Ileal Bladder Augmentation: Defining Techniques and Potential Pitfalls

Passerotti, Carlo C.; Nguyen, Hiep T.; Lais, Alberto; Dunning, Patricia; Harrell, Bruce; Estrada, Carlos R.; Lee, Richard; Retik, Alan B.; Peters, Craig A.

doi:10.1089/end.2007.0238

Cited by 33 publications

(7 citation statements)

References 13 publications

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“…The data from the Lahey clinic initial robotic-assisted ileovesicostomy was also compared to data from open ileovesicostomies performed at the same institution. Additionally, our initial results are similar to other open series [2, 17]. …”

Section: Discussionsupporting

confidence: 90%

Completely intracorporeal robotic-assisted laparoscopic ileovesicostomy: initial results

et al. 2014

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We present a series of robotic-assisted laparoscopic ileovesicostomies with bowel work performed completely intracorporeally. The four patients selected for this procedure were all diagnosed with neurogenic bladder and failed conservative medical therapy. Preoperative patient data included age, body mass index (BMI), and urodynamic (UD) study results. Intra-operative data included estimated blood loss (EBL), operative time, and intra-operative complications. Post-operative data included return to bowel function, post-operative complications, and length of hospital stay (LOS). All bowel work was completed intracorporeally with the exception of stoma maturation. Four robotic ileovesicostomies were performed. Pre-operative urodynamic study results showed either elevated detrusor pressures or limited bladder capacities in addition to the inability to perform self-catheterization. The mean patient age was 40 years and mean BMI was 26 kg/m2. Average EBL and operative time were 131 ml and 290 min, respectively. No intra-operative complications occurred. Bowel function, as defined as flatus, returned on average 3.8 days after surgery and average LOS, defined as discharge home or discharge to the spinal cord unit, was 7.5 days. Mean follow-up time was 25.8 months. Post-operative urodynamic studies revealed low stomal leak point pressure (<10 cmH2O). This study is the first to describe a completely intracorporeally robotic-assisted laparoscopic ileovesicostomy with safe and effective outcomes after more than 2 years of follow-up.

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Section: Discussionsupporting

confidence: 90%

Completely intracorporeal robotic-assisted laparoscopic ileovesicostomy: initial results

et al. 2014

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“…Furthermore, they proposed that the risk of incisional hernia would be decreased due to the lack of a much larger incision required for an extracorporeal anastomosis [7]. The only study suggesting that bowel anastomosis is not ideally performed intracorporeally is a study by Passerotti and colleagues in which they performed intracorporeal bowel anastomosis on five swine during ileal bladder augmentation [11]. They reported leakage of one bowel-to-bowel anastomosis and determined that it was due to the poor visualization of the backside of the anastomosis during the procedure.…”

Section: Discussionmentioning

confidence: 99%

Completely Intracorporeal Robotic-Assisted Laparoscopic Ileovesicostomy

Dolat

Wade

Grob

et al. 2014

Case Reports in Urology

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We present a report of a completely intracorporeal robotic-assisted laparoscopic ileovesicostomy with long term follow-up. The patient was a 55-year-old man with paraplegia secondary to tropical spastic paresis resulting neurogenic bladder dysfunction. The procedure was performed using a da Vinci Surgical system (Intuitive Surgical, Sunnyvale, CA) and took 330 minutes with an estimated blood loss of 100 mL. The patient recovered without perioperative complications. He continues to have low pressure drainage without urethral incontinence over two years postoperatively.

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“…Finally, Passerotti et al [10] reported in a porcine model that due to leaks with intracorporeal attempts at bowel anastamosis, this portion of the surgery was best done extracorporeally. The encouraging results from this series, however, demonstrate that this is not the case, as it is feasible to do the bowel anastamosis intracorporeally.…”

Section: Discussionmentioning

confidence: 99%

The University of Chicago technique of complete intracorporeal pediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy

2009

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We present the University of Chicago technique for complete intracorporeal robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy. The operative steps of the open procedure were replicated laparoscopically using robotic assistance. Initially, five transperitoneal laparoscopic ports are placed prior to docking the da Vinci S robotic system. A 20 cm ileal segment is isolated, and the gastrointestinal anastomosis is performed in an end-to-end fashion using intracorporeal suturing. The appendix is anastomosed to the right posterior wall of the bladder over an 8F feeding tube in an extravesical fashion. Then, the bladder is incised in a coronal plane, and the simple detubularized ileal on-lay patch is anastomosed to the posterior and anterior walls of the bladder. A suprapubic catheter and pelvic drain are placed. Finally, the Mitrofanoff stoma is then fashioned. Cystography is done at 4 weeks postoperatively. This report suggests that robotic-assisted ileocystoplasty and appendicovesicostomy is feasible. A reasonable outcome with early recovery, resumption of normal activities, and excellent cosmesis can be achieved in select patients. A large case series, however, is necessary to determine whether a robotic-assisted approach provides any significant advantages over conventional open procedures.

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Robot-Assisted Laparoscopic Ileal Bladder Augmentation: Defining Techniques and Potential Pitfalls

Cited by 33 publications

References 13 publications

Completely intracorporeal robotic-assisted laparoscopic ileovesicostomy: initial results

Completely intracorporeal robotic-assisted laparoscopic ileovesicostomy: initial results

Completely Intracorporeal Robotic-Assisted Laparoscopic Ileovesicostomy

The University of Chicago technique of complete intracorporeal pediatric robotic-assisted laparoscopic augmentation ileocystoplasty and Mitrofanoff appendicovesicostomy

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