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Related Experiment Videos

The Hautmann neobladder with a chimney: a versatile modification

M C Lippert1, D Theodorescu

  • 1Department of Urology, University of Virginia Health Sciences Center, Charlottesville, USA.

The Journal of Urology
|September 25, 1997
PubMed
Summary

This study introduces a modified Hautmann ileal neobladder with a chimney technique. This surgical modification enhances flexibility and reduces complications, making ileal neobladder diversion suitable for more patients.

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Area of Science:

  • Urology
  • Surgical Innovation
  • Reconstructive Surgery

Background:

  • The Hautmann ileal neobladder is a common urinary diversion technique.
  • Certain anatomical challenges, such as short ureters, can limit its applicability.
  • Existing methods may have limitations in flexibility and potential complications.

Purpose of the Study:

  • To describe a modification of the Hautmann ileal neobladder using a "chimney" for ureterointestinal anastomosis.
  • To enhance the flexibility of the neobladder construction.
  • To reduce surgical pitfalls and expand candidacy for ileal neobladder diversion.

Main Methods:

  • A modification of the standard Hautmann ileal neobladder technique was developed.
  • An additional 5-10 cm of small bowel was used to create a "chimney" for ureterointestinal anastomosis.

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  • The neobladder neck was created to facilitate an end-to-end urethrointestinal anastomosis.

    • Main Results:

    • The modified procedure was performed on 3 patients between March and October 1996.
    • Two patients received right chimneys, and one received a left chimney.
    • One patient experienced transient postoperative small bowel obstruction; otherwise, no complications were noted. Two patients achieved complete continence, and one had occasional nocturnal incontinence.

    Conclusions:

    • This modification offers increased versatility, particularly for patients with short ureters.
    • It minimizes mesenteric tension on the urethrointestinal anastomosis and simplifies the procedure.
    • The technique allows for easier postoperative revision or resection if necessary.