404 / 492
VR-43
(VS)
ALL INTRACORPOREAL ROBOT ASSISTED LAPAROSCOPIC AUGMENTATION
ILEOCYSTOPLASTY FOR A 11-YEAR-OLD-BOY PATIENT: INITIAL EXPERIENCE IN
TURKEY
Yusuf KIBAR, Serdar YALCIN and Burak KOPRU
Gulhane Military Medical Academy/Ankara/Turkey, Urology, Ankara, TURKEY
PURPOSE
Augmentation cystoplasty can be performed by open surgery, laparoscopic and robot-assisted laparoscopy. In this
video, we wanted to share our robotics augmentation ileosistoplasty experience in 11-year-old male patient with a
diagnosis of neurogenic bladder.
MATERIAL AND METHODS
Patients and methods: 11-year-old male patient treated with clean intermittant catheterization and anti-cholinergic
therapy for neurogenic bladder. Bladder capacity was detected 180cc, the irregularities in the bladder contour and left
grade 1 VUR was detected in control video urodynamics. So we decided to implement robotic augmentation
ileocystoplasty to the patients.
RESULTS
The transperitoneal approach is used for the procedure. The abdomen was insufflated using CO
2
and trocars placed
under direct vision.( 1 of camera port (12 mm), 3 of da Vinci ports (8 mm) was placed and 1 of 5 mm and 1 of 10 mm
assistant ports were placed.) A 30 cm segment of ileum with mesentery was incised with about 30 cm proximal from the
ileocecal valve and this segment was suspended. Intestinal anastomosis was performed with 4-0 vicril and 4-0 monocril
sutures and created an u-shaped ileal pouch. The bladder was released from the surrounding tissue. About 8 cm,
longitudinal incision was made to the bladder. A single-J catheters were placed to the left ureter and bladder for the left
ureteral catheter and cystostomy. The bowel prepared for bladder augmentation and it was sutured with 4.0 PDS with
water tight anastomosis. Operation was terminated by placing the drainage catheter.
CONCLUSIONS
Robotic augmentation ileocystoplasty is preferred minimally invasive surgical approach by a lower morbidity than open
surgery, less blood loss and the because of the short duration of hospital stay.