Safety and feasibility of laparoscopic appendicovesicostomy in children

Mitrofanoff appendicovesicostomy is needed for securing a conduit for clean intermittent catheterization in children with myelomeningocele, posterior urethral valves and non-neuropathic neuropathic bladder. An open technique is widely used; herein we report our initial experience with minimally invasive laparoscopic appendicovesicostomy in children.

During 2007-2011 we operated on 4 male children with a mean age of 6 years (3-9) suffering from posterior urethral valves (1), myelomeningocele (2), and non-neuropathic neuropathic bladder (1). A posterior Mitrofanoff trough was used in one child while in the remaining children we used the anterior Mitrofanoff trough.

The mean operative time was 3.5 h (3-5). The mean hospital stay was 3.7 days (2-5). The mean follow up was 12.5 months (5-30). All are continent; one child was converted to open because of failure to pass the catheter at the end of the procedure. Cosmetic aspect is perfect. No difficulty in catheterization was encountered.

Laparoscopic Mitrofanoff is a feasible, safe and effective technique associated with low morbidity.