Laparoscopic intracorporeally constructed ileal conduit after porcine cystoprostatectomy

Purpose: We present our technique of laparoscopic ileal conduit creation af ter cystoprostatectomy in a porcine model performed in a completely intraco rporeal manner. Materials and Methods: After developing the technique in 5 acute animals la paroscopic cystoprostatectomy with intracorporeally performed ileal conduit urinary diversion was performed in 10 surviving male pigs. A 5-port transp eritoneal technique was used. All steps of the technique applied during ope n surgery were duplicated intracorporeally. Specifically cystectomy, isolat ion of an ileal conduit, restoration of bowel continuity and mucosa-to-muco sa stented bilateral ileoureteral anastomosis formation were performed by e xclusively intracorporeal laparoscopic techniques. Results: Surgery was successful in all 10 study animals without intraoperat ive or immediate postoperative complications. Blood loss was minimal and av erage operative time was 200 minutes. Stenosis of the end ileal stoma speci fically at the skin level was noted in 6 animals. Three deaths occurred 2 t o 3 weeks postoperatively. At sacrifice renal function was normal in all su rviving animals. No ileo-ureteral anastomotic strictures were noted on pre- sacrifice radiography of the loop or at autopsy examination of the anastomo tic sites. Conclusions: Laparoscopic ileal conduit urinary diversion after cystoprosta tectomy may be performed completely intracorporeally in the porcine model. Clinical application of this technique is imminent.