Robotic-assisted laparoscopic bladder augmentation in the pediatric patient

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• 作者：A.C. Wiestma ; C.R. Estrada Jr. ; P.S. Cho ; ^{patricia.cho@childrens.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; M.V. Hollis ; R.N. Yu
• 关键词：Spina bifida ; Neurogenic bladder ; Bladder augmentation ; Robotic surgery
• 刊名：Journal of Pediatric Urology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：12
• 期：5
• 页码：313.e1-313.e2
• 全文大小：138 K

文摘

Bladder augmentation is a common surgical intervention for neuropathic bladder dysfunction, and has conventionally been an open procedure. We present a robotic ileocystoplasty to demonstrate the feasibility of an entirely intracorporeal approach in a pediatric patient.

Methods

The patient was a 6 year old (18.5 kg) boy with a neurogenic bladder secondary to lumbar myelomeningocele. Urodynamics revealed a small capacity and poorly compliant bladder and he was incontinent between frequent catheterizations. A robotic augmentation cystoplasty was performed.

Results

At one-month postoperatively, a cystogram revealed no urine leak, and the suprapubic tube was removed. The patient resumed CIC every 3 h during the day and once overnight until postoperative urodynamic studies confirmed safe dynamics, after which the CIC interval was lengthened.

Conclusion

Robotic bladder augmentation is safe and feasible in a select pediatric population. The entire procedure including preparation of the bowel segment can be completed intracorporeally, even in smaller children.