Laparoscopic ileal conduit: Five-year follow-up

Objectives, To report the techniques used for intracorporeal laparoscopic c onstruction of an ileal conduit urinary diversion and long-term patient fol low-up after this procedure. Methods, A 28-year-old man with cerebral palsy, a neurogenic bladder, and v oiding dysfunction was referred for definitive management of his urinary tr act after several episodes of pyelonephritis, A conduit urinary diversion w as performed using a 5-port, transabdominal approach. An appropriate length of ileum was used for diversion, and ureterointestinal anastomoses were pe rformed using a modified Bricker technique. All aspects of the procedure we re performed intracorporeally, including isolation of conduit, bowel reanas tomosis, ureteral mobilization, and ureterointestinal anastomosis. A 12-mm port site was enlarged and used as the stoma, which was constructed in rout ine fashion. Results, Five years after surgery, this patient had normal and stable renal function, with a serum creatinine of 0.8 mg/dL. Serial imaging studies con tinued to reveal prompt and symmetric renal function and no evidence of obs truction or reflux. Conclusions. Laparoscopic ileal conduit construction is feasible and can pr ovide durable results. Although technically challenging, ongoing technical refinements will make performance of reconstructive laparoscopy more widely applicable. Larger series with substantial follow-up will help illuminate the place of laparoscopic noncontinent urinary diversion in the surgical ar mamentarium. UROLOGY 56: 22-25, 2000, (C) 2000, Elsevier Science Inc.