A MODIFIED MITROFANOFF PROCEDURE USING THE RECTUS-ABDOMINIS MUSCLE FLAP TECHNIQUE - A PRELIMINARY-REPORT IN A RABBIT MODEL

Objective To create a modified Mitrofanoff continent stoma in a rabbit model, using a rectus abdominis muscle flap (RAMF) with its intact va scular supply. Materials and methods Fifteen New Zealand White male ra bbits underwent an operation to create a 6 cm long tube using a RAMF w ith its vascular pedicle from the inferior epigastric vessels, The int ernal orifice of the tube was anastomosed to the anterior bladder wall with 5/0 polyglactin sutures. The external orifice was directly sutur ed to the skin to fashion a catheterizable Mitrofanoff stoma, A 6 F ca theter was left in the tube as a stent for 2 weeks, Radiography and hi stopathological investigations were carried out for 8 weeks after surg ery. Results Intravenous pyelography and voiding cystourethrography sh owed a normal looking urinary system; contrast studies showed an intac t RAMF tube with no signs of stricture. Catheterization of the stoma w as possible in each animal, Histopathologically, there was no evidence of severe fibrosis or inflammatory changes: the inner surface of the tube (proximal bladder side) was covered by transitional urinary epith elium in most of the animals, Conclusion It is possible to create a Mi trofanoff tube using a vascularized RAMF in a rabbit model, Using this technique there is no need to perform a major operation in the gastro intestinal system. The technique may provide a good alternative treatm ent in those patients who need a combination of Mitrofanoff and antegr ade continence enema surgery, and in patients with previous appendecto my.