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Endoscopic Mic-Key button placement for continent vesicostomy.

Isabelle Lacreuse1, François Becmeur, Celine Dheu

  • 1Department of Pediatric Surgery, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France. isabelle.talon2@chru-strasbourg.fr

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 1, 2009
PubMed
Summary

Percutaneous button vesicostomy offers a safe, minimally invasive method for bladder emptying in patients with neurogenic bladder when other methods fail. This technique provides a reversible alternative to major surgery.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Pediatric Surgery

Background:

  • Intermittent bladder emptying is crucial for patients with neurogenic bladder.
  • Traditional methods like urethral catheterization may be challenging or impossible.
  • Surgical options like Mitrofanoff continent urinary diversion can be extensive.

Purpose of the Study:

  • To describe a novel percutaneous button vesicostomy placement technique.
  • To evaluate the safety and feasibility of this minimally invasive approach.
  • To offer an alternative to more invasive urinary diversion procedures.

Main Methods:

  • Utilized a percutaneous gastrostomy kit under cystoscopic control.
  • Employed the U-stitch technique to secure the bladder to the anterior abdominal wall.
  • Placed a gastrostomy button (Mic-Key) following dilation of the tract.

Main Results:

  • Performed 10 percutaneous continent vesicostomies over 2 years in patients aged 5 months to 19 years.
  • The procedure demonstrated safety with no major complications observed.
  • Only minor complications were reported during the study period.

Conclusions:

  • Percutaneous button vesicostomy is a safe and feasible option for intermittent bladder emptying.
  • This minimally invasive technique may avoid the need for more significant surgical interventions.
  • Further evaluation with larger patient series is warranted to confirm efficacy.