|
|
 |
| |
Back to Scientific Program
Back to Annual Meeting
Implications Of Bladder Capacity On Laparoscopic Transvesicle Ureteral Reimplantation
Alexander Kutikov, Thomas J Guzzo, Daniel J Canter, Pasquale Casale
Children's Hospital of Philadelphia, Philadelphia, PA
Introduction: Laparoscopic transvesicle ureteral reimplantation with or without robotic assisted surgical devices is being developed as an alternative to open surgery. The current study sought to review our experience with pure laparoscopic technique and to determine whether bladder capacity influenced outcome and complication rate.
Methods: 32 patients underwent vesicoscopic reimplantation by the same surgeon. The patients had the following pathologies: 5 patients with primary obstructing megaureters (POM) and 27 with vesicoureteric reflux (VUR). The patients were divided into groups based on bladder capacity as measured by a voiding cystourethrogram (VCUG). The operation was performed via a transvesicle laparoscopic cross-trigonal ureteral reimplanation for VUR and a Glenn-Anderson reimplantation for POM, using two 3 mm working ports and a 5mm camera port.
Results: The operative success rates were 92.6% and 80% for the VUR and POM patients respectively. Complications included a postoperative urinary leak in 12.5% (4/32) and ureteral stricture at the neoureterovesicle anastomosis in 6.25% (2/32) of the patients. The majority of complications occurred in the patients with a bladder capacity less than 130 ml.
Conclusions: Laparoscopic intravesicle reimplantation is in its infancy and appears to have a higher complication rate when patient bladder capacity is less than 130 ml.
Complications and surgical failures grouped by bladder size.| Stratification of Pts by Bladder Volume | # of Pts | Complications | Surgical Failures | | Group 1 (<130 cc) | 7 | 3 urinary leaks; 2 ureteral strictures at anastamosis | 2 persistant VUR | | Group 2 (131-215 cc) | 14 | 1 urinary leak | none | | Group 3 (>215 cc) | 11 | none | none |
Back to Scientific Program
Back to Annual Meeting
|
|
| |
|
|
| |
|
|
|
|
