Robot-Assisted Laparoscopic Augmentation Enterocystoplasty with Antegrade Continence Enema

Abstract

Introduction:

We demonstrate a technique for robot-assisted laparoscopic augmentation enterocystoplasty with antegrade continence enema (ACE). These two steps have traditionally been performed as two distinct procedures with separate open incisions. To our knowledge, this is the first published report showing a combined robotic technique.

Materials and Methods:

The surgery was performed transperitoneally using four ports. The procedure began with creation of the ACE. This was followed by isolation of an ileal segment and detubularization of this segment with a harmonic scalpel. The U-patch was then ready for anastomosis.

Results and Conclusions:

In our experience, patients tolerate this procedure well, and all postoperative studies show improvement. Although surgical time for our first robot-assisted augmentation enterocystoplasty was around 13.5 h, our times are now significantly reduced. After performing ∼20 robotic augmentations, some with ACE, mean surgical time for our most recent procedures is 7 h (ranging from 5:45 to 7:55). In conclusion, robot-assisted laparoscopic augmentation enterocystoplasty with ACE is safe, efficient, and efficacious.

No competing financial interests exist.

Runtime of video: 9 mins 52 secs