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The serous-lined tunnel principle for urinary reconstruction: a more rational method
1Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan. kart@hsp.md.shinshu-u.ac.jp
BJU International
|June 20, 2001
Summary
The serous-lined tunnel principle is a feasible technique for urinary reconstruction, successfully creating orthotopic neobladders, continent diversions, and ureteric replacements with good function and no reflux.
Area of Science:
- Urology
- Surgical Innovation
- Reconstructive Surgery
Background:
- Urinary reconstruction presents challenges in achieving reliable antireflux mechanisms and continent diversion.
- The serous-lined tunnel principle offers a potential solution for ureteric implantation and continent valve construction.
Purpose of the Study:
- To evaluate the feasibility and outcomes of the serous-lined tunnel principle in various urinary reconstruction procedures.
- To assess its application in orthotopic neobladders, continent cutaneous diversions, and intestinal ureteric replacements.
Main Methods:
- The serous-lined tunnel principle was applied to create orthotopic ileal neobladders (16 patients), continent ileal pouches (10 patients), and ileal ureters (2 patients).
- A tubularized colonic segment was used for ureteric replacement in one patient with a continent transverse colon pouch.
Main Results:
- All 52 ureters implanted into neobladders or pouches demonstrated good function without obstruction or reflux.
- Continent valves (11) were continent, and ileal ureters showed no reflux and reduced hydronephrosis.
- The technique facilitated unidirectional flow into the pouch.
Conclusions:
- The serous-lined tunnel principle is a versatile and effective method for ureteric reimplantation and continent valve formation in urinary reconstruction.
- Creative applications of this principle hold promise for future reconstructive urological procedures.