Laparoscopic Ileovesicostomy

HSU, THOMAS H. S.
RACKLEY, RAYMOND R.
ABDELMALAK, JOSEPH B.
TCHETGEN, MARIE-BLANCHE
MADJAR, SHAHAR
VASAVADA, SANDIP P.

From the Section of Voiding Dysfunction and Female Urology, Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio

Accepted for publication February 22, 2002.

^{* Financial interest and/or other relationship with Boston Scientific.}

† Financial interest and/or other relationship with Pharmacia and Ortho McNeil.

Journal of Urology 168(1):p 180-181, July 2002.

Purpose

We present our initial experience with laparoscopic ileovesicostomy for managing neurogenic bladder.

Materials and Methods

A 5 port transperitoneal approach was used for laparoscopic ileovesicostomy. After bladder preparation a 17 cm. ileal segment was harvested and used as the urinary conduit. Ileovesical anastomosis was formed using intracorporeal suturing and knot tying techniques.

Results

Operative time was 4 hours. Blood loss was less than 100 ml. Physical activity and oral intake resumed on postoperative day 1 and the patient was discharged home on postoperative day 3. The postoperative narcotic requirement was 4 mg. morphine sulfate equivalent. There were no intraoperative or postoperative complications.

Conclusions

Laparoscopic ileovesicostomy in this initial experience was associated with acceptable operative time and minimal postoperative morbidity. It may serve as an excellent minimally invasive alternative to conventional open ileovesicostomy.