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Laparoscopic Assisted Continent Urinary Diversion in the Pig

1995; Lippincott Williams & Wilkins; Volume: 154; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(01)66829-0

1527-3792

Kevin R. Anderson, Paul T. Fadden, Kurt Kerbl, Elspeth M. McDougall, Ralph V. Clayman,

Pediatric Urology and Nephrology Studies

No AccessJournal of UrologyInvestigative Urology1 Nov 1995Laparoscopic Assisted Continent Urinary Diversion in the Pig Kevin R. Anderson, Paul T. Fadden, Kurt Kerbl, Elspeth M. McDougall, and Ralph V. Clayman Kevin R. AndersonKevin R. Anderson More articles by this author , Paul T. FaddenPaul T. Fadden More articles by this author , Kurt KerblKurt Kerbl More articles by this author , Elspeth M. McDougallElspeth M. McDougall More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66829-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The ideal urinary reservoir would be low pressure, nonrefluxing and simple to construct. Hohenfellner recently described creating an in situ ureterosigmoidostomy with a 5 to 6 cm. detubularized portion of sigmoid colon and rectum (sigmoid-rectum pouch). In an effort to further study the reconstructive applications of laparoscopy, we sought to laparoscopically create a sigmoid-rectum pouch in an animal model. In addition, we sought to compare a "dunked" (right ureter) with a hand-sewn end-to-side ureterocolonic anastomosis (left ureter). Materials and Methods: Nine male domestic pigs underwent laparoscopic creation of a continent urinary diversion. Pouch creation and the ureterocolonic anastomoses were done extracorporeally; ureteral stents were not used. Average operative time was 122 minutes. Eight pigs survived the 10 to 12 week study period. Results: Mean pouch capacity was 360 cc and pouch pressure remained less than 20 cm.H2 O. Stones were noted on the bowel staple line in 44 percent of the animals. Ureterocolonic obstruction occurred in 11 percent of the right ureters and 33 percent of the left ureters. Conclusions: A laparoscopically created continent sigmoid-rectum diversion appears to be feasible. A "dunked" ureterocolonic anastomosis provides equivalent or better drainage than a traditional hand-sewn ureterocolonic anastomosis. Problems with stone formation on the titanium staple line need to be resolved. References 1 : Mainz pouch II (sigma rectum pouch). J. Urol.1993; 149: 258. Abstract, Google Scholar 2 : Pediatric urinary diversion: review and own experience. Eur. Urol.1992; 22: 177. Google Scholar 3 : Rat model for carcinogenesis in ureterosigmoidostomy. Science1980; 207: 1079. Google Scholar 4 : Le reservoir ileal de substitution apres la cystectomie totale chez l'homme. J Urol. (Paris)1951; 57: 408. Google Scholar 5 : Rapid communication of right colon pouch. Curr. Surg. Tech. Urol.1993; 6: 1. Google Scholar 6 : Orthotopic intestinal substitutes for bladder using detubularized ileum. In: Bladder Reconstruction and Continent Urinary Diversion. Edited by . St. Louis: Mosby Year Book1991: 387. Google Scholar 7 : The development of the continent ileal reservoir in patients requiring urinary diversion or bladder replacement. In: Bladder Reconstruction and Continent Urinary Diversion. Edited by . St. Louis: Mosby Year Book1991: 263. Google Scholar 8 : The pathophysiology of hyperchloremic metabolic acidosis after urinary diversion through intestinal segments. Surgery1985; 98: 561. Google Scholar 9 : Chlorpromazine: adjuvant therapy for the metabolic derangements created by urinary diversion through intestinal segments. J. Urol.1985; 134: 165. Link, Google Scholar 10 : Nicotinic acid: treatment for the hyperchloremic acidosis following diversion through intestinal segments. J. Urol.1985; 134: 162. Abstract, Google Scholar 11 : Ureterosigmoidostomy and bladder extrophy: a long-term follow-up. J. Urol.1990; 136: 396. Google Scholar 12 : Nonrefluxing colonic conduits: a long-term life table analysis. J. Urol.1989; 142: 1201. Abstract, Google Scholar 13 : Surveillance colonoscopy and biopsy in patients with ureterosigmoidostomy. Endoscopy1987; 19: 60. Google Scholar 14 : Malignancies in bladder augmentation and intestinal conduits. J. Urol.1990; 143: 671. Link, Google Scholar Department of Surgery (Urology), Yale University, New Haven, Connecticut, the Department of Surgery (Urology), Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri and Wels Medical Center, Wels, Austria.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByGrubb R, Sundaram C, Yan Y, Chen C, McDougall E and Clayman R (2018) Use Of Titanium Staples During Upper Tract Laparoscopic Reconstructive Surgery: Initial ExperienceJournal of Urology, VOL. 168, NO. 4 Part 1, (1366-1369), Online publication date: 1-Oct-2002.FERGANY A, GILL I, KAOUK J, MERANEY A, HAFEZ K and SUNG G (2018) LAPAROSCOPIC INTRACORPOREALLY CONSTRUCTED ILEAL CONDUIT AFTER PORCINE CYSTOPROSTATECTOMYJournal of Urology, VOL. 166, NO. 1, (285-288), Online publication date: 1-Jul-2001.TÜRK I, DEGER S, WINKELMANN B, SCHÖNBERGER B and LOENING S (2018) LAPAROSCOPIC RADICAL CYSTECTOMY WITH CONTINENT URINARY DIVERSION (RECTAL SIGMOID POUCH) PERFORMED COMPLETELY INTRACORPOREALLY: THE INITIAL 5 CASESJournal of Urology, VOL. 165, NO. 6 Part 1, (1863-1866), Online publication date: 1-Jun-2001. Volume 154Issue 5November 1995Page: 1934-1938 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Kevin R. Anderson More articles by this author Paul T. Fadden More articles by this author Kurt Kerbl More articles by this author Elspeth M. McDougall More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF DownloadLoading ...