PEDIATRIC CONTINENT RESERVOIRS AND COLOCYSTOPLASTY CREATED WITH ABSORBABLE STAPLES

Purpose: For patients undergoing continent urinary diversion or bladde r augmentation the process of detubularization and refashioning bowel into a spherical, configuration is often tedious and time-consuming, a nd may cause undesirable blood loss. We sought to determine whether us ing absorbable staples in a pediatric population was safe, effective a nd economical. Materials and Methods: We performed our technique of ra pid right colon pouch construction in 18 children (average age 12.3 ye ars) undergoing continent urinary diversion (8) or colocystoplasty (10 ). We evaluated the cost of performing the procedure relative to conve ntional suturing as well as the results of up to 3 years of followup. Results: In all cases pouch construction using absorbable staples was performed easily and rapidly, and resulted in minimal blood loss. Usin g the staples decreased operative time by approximately 1 hour and sav ed nearly $350 per case. Only 1 significant complication requiring sur gical intervention developed during extended followup (delayed pouch r upture) and in that case the use of absorbable staples did not contrib ute to morbidity. None of the patients had reservoir stones. Conclusio ns: The use of devices applying absorbable staples in conjunction with a 1-step method of colonic reservoir construction proves to be effect ive and economically sound for continent urinary diversion and bladder augmentation.