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A Simple Neobladder Using a Porcine Model: The Double Limb U-Pouch.

Ryan P Werntz¹, Poone Shoureshi¹, Kyle Gillis¹

¹Oregon Health and Science University, Portland, OR.

|December 6, 2017

Summary

This summary is machine-generated.

The double-limb U-Pouch (D-LUP) neobladder offers a simple construction with a larger capacity and similar compliance to other models. This orthotopic diversion shows promise for robotic surgery applications.

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Area of Science:

Urology
Surgical Innovation
Biomedical Engineering

Background:

Orthotopic neobladder construction is a key component of urinary diversion following cystectomy.
Existing neobladder techniques, such as Studer and Camey I, have established capacities and compliances.
The development of novel neobladder designs aims to improve functional outcomes and surgical applicability.

Purpose of the Study:

To create a novel, simple neobladder design: the double-limb U-Pouch (D-LUP).
To evaluate the capacity and compliance of the D-LUP neobladder in comparison to established models (Studer, Camey I).
To assess the feasibility of the D-LUP for orthotopic urinary diversion, particularly in robotic surgery.

Main Methods:

Neobladders (Camey I, spherical, and D-LUP) were constructed from 40-cm segments of porcine small intestine.
Comparative analysis focused on cystometric capacity, compliance, and pouch-to-urethra anastomotic distance.
Animal tissue (pig kidneys, ureters, bladders, small intestine) was utilized post-autopsy under approved protocols.

Main Results:

The D-LUP neobladder demonstrated the largest cystometric capacity (430 mL) at 30 cm H2O, exceeding Camey I (250 mL) and Studer (350 mL).
Compliance was comparable across the studied neobladders: D-LUP (16 mL/cm H2O), spherical (15 mL/cm H2O), and Camey I (10 mL/cm H2O).
The D-LUP achieved a pouch-to-urethra anastomotic distance of 0 cm, similar to the Camey I, and shorter than the spherical reservoir (10 cm).

Conclusions:

The D-LUP neobladder is a simple-to-construct orthotopic diversion with a more dependent ileo-urethrostomy.
It exhibits a larger capacity and comparable compliance to spherical neobladders.
The D-LUP design shows potential for application in robotic surgery, supported by laboratory data.