EXPERIMENTAL AND CLINICAL URINARY-DIVERSI ON

In order to achieve an appropriate technical experience and explore cl inical feasibility of laparoscopic urinary diversion, the authors plan ned a laboratory experiment. In ten male pigs weighing about 25 kilogr ams cystoprostatectomy was performed. Ureterocutaneostomy or ureterosi gmoidostomy were carried out next. For ureterocutaneostomy a channel w as bluntly dissected through the abdominal wall. The ureter was graspe d by a clamp passed through the stroma, drawn outside and anstomosed t o the skin. Operative time was about 30 minutes. For ureterosigmoidost omy a longitudinal incision of approximately 1 cm was made through the wall of the sigmoid colon in order to reach the mucosa. A very small opening in the angle of the incision was made. A suture was placed in the ureteral tip and secured to the colon wall. Finally, the ureter wa s covered in its bed with antireflux technique. Operative time was abo ut 180 minutes. Laparoscopic ureterocutaneostomy was also successfully applied in a compromised patient to resolve a particular clinical sit uation.In order to achieve an appropriate technical experience and exp lore clinical feasibility of laparoscopic urinary diversion, the autho rs planned a laboratory experiment. In ten male pigs weighing about 25 kilograms cystoprostatectomy was performed. Ureterocutaneostomy or ur eterosigmoidostomy were carried out next. For ureterocutaneostomy a ch annel was bluntly dissected through the abdominal wall. The ureter was grasped by a clamp passed through the stroma, drawn outside and ansto mosed to the skin. Operative time was about 30 minutes. For ureterosig moidostomy a longitudinal incision of approximately 1 cm was made thro ugh the wall of the sigmoid colon in order to reach the mucosa. A very small opening in the angle of the incision was made. A suture was pla ced in the ureteral tip and secured to the colon wall. Finally, the ur eter was covered in its bed with antireflux technique. Operative time was about 180 minutes. Laparoscopic ureterocutaneostomy was also succe ssfully applied in a compromised patient to resolve a particular clini cal situation.