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A new approach to orthotopic bladder replacement using the transplanted bowel segment.
N Yamanaka1, K Kimura, M Fujisawa
1Division of Urology, Shinko Hospital, Kobe, Japan.
Techniques in Urology
|August 30, 2000
Summary
This study shows a new technique for bladder augmentation using a transplanted bowel segment in dogs. This method is functional and leak-free, offering a solution for difficult orthotopic neobladder surgeries.
Area of Science:
- Urology
- Surgical Innovation
- Animal Models
Background:
- Orthotopic neobladder construction can be challenging due to limited colonic mesentery length.
- Augmenting the bladder is crucial in cases with anatomical restrictions.
Purpose of the Study:
- To evaluate the feasibility of autotransplanting a free intestinal segment for bladder augmentation.
- To address surgical difficulties in orthotopic neobladder creation.
Main Methods:
- An animal feasibility study was conducted using eight female dogs.
- A bowel segment was transected and revascularized between the ileal artery and internal iliac artery.
- Orthotopic bladder replacement was performed utilizing the transplanted bowel segment.
Main Results:
- The autoaugmented bladder using the transplanted bowel segment demonstrated functionality.
- No instances of leakage were observed during follow-up studies.
- The procedure proved successful in the canine model.
Conclusions:
- Autotransplantation of an intestinal segment is a feasible technique for bladder augmentation.
- This method is particularly useful when mechanical difficulties arise in anastomosing the urinary reservoir to the urethra.
- The procedure warrants further clinical evaluation for challenging orthotopic neobladder cases.