Laparoscopic intracorporeally-constructed Ileal conduit after porcine cystoprostatectomy

ABSTRACT

Introduction and Objectives: ileal conduit urinary diversion following cystoprostatectomy has not been reported by the laparoscopic intrracorporeal technique to date. Herein, we present our technique of laparoscopic ileal conduit following cystoprostatectomy in the porcine model performed in a completely intracorporeal manner. After developing the technique in 5 acute animals, laparoscopic cystoprostatectomy with intracoporeally performed ileal conduit urinary diversion was performed in 10 male survival pigs. A 5-port transperiloneal technique was used. All steps of the technique as applied during open surgery were duplicated intracorporeally, Specifically, cystectomy, isolation of an ileal conduit, restoration of bowel continuity, and mucosa to mucosa, stented bilateral ileoureteral anastomosis were performed with exclusively intracorporeal laparoscopic techniques. Surgery was successful in all 10 study animals without intraoperative or immediate postoperative complications. Blood loss was minimal and operating time 'averaged 290 minutes. An end ileal stoma was formed at the right lower quadrant port site. At euthanasia, renal function was normal in all surviving animals. No ileoureteral anastomotic strictures were noted on pre-euthanasia loopgrams or on post-mortem examination of the anastomotic sites. Laparoscopic ileal conduit urinary diversion .following cystoprostatectomy can be performed completely intracorporeally in the porcine model. Clinical application of this technique is imminent