Laparoscopic enterocystoplasty

Objectives. To report the initial clinical experience with laparoscopic aug mentation enterocystoplasty using the ileum, sigmoid, or right colon. Methods. Three patients with functionally reduced bladder capacities due to neurogenic causes underwent laparoscopic enterocystoplasty: ileocystoplast y (n = 1), sigmoidocystoplasty (n = 1), and cystoplasty with cecum and prox imal ascending colon (n = I). In the last patient, a continent, catheteriza ble, ileal conduit with an umbilical stoma was also created. In all patient s, bower reanastomosis was performed by exteriorizing the bowel loop outsid e the abdomen through a 2-cm extension of the umbilical port site. Creation of a large cystotomy, mobilization of the appropriate bowel segment, and t he circumferential enterovesical anastomosis were all performed intracorpor eally by laparoscopic techniques. Results, The operative times were 5.3, 8, and 7 hours. Ail three laparoscop ic enterovesical anastomoses were watertight, without postoperative urinary extravasation. The hospital stay was 7, 5, and 4 days. Conclusions. Laparoscopic enterocystoplasty is feasible, safe, and efficaci ous and appears to be an attractive alternative to open enterocystoplasty. Various bowel segments can be used as with open surgery, including creation of a continent, catheterizable stoma. Although further technical refinemen ts will undoubtedly occur, even at this early stage, it is clear that the t echnical steps of an enterocystoplasty can be satisfactorily and effectivel y performed laparoscopically. (C) 2000, Elsevier Science Inc.