V248: Robotic Augmentation Enterocystoplasty and Appendicovesicostomy

Video

Introduction and Objectives
Robotic technology has been applied to many surgical procedures in Urology. We demonstrate our technique for robotic augmentation enterocystoplasty in performed completely intracorporeal fashion. A catheterizable channel can be performed concomitantly.

Methods
Ports are placed in a fashion similar to a robotic prostatectomy, with the camera above the umbilicus, and three robot ports placed 9cm apart. The fourth arm is placed on the left side. An additional port is placed in the left upper quadrant for the bedside assistant. The ileum is mobilized laparoscopically. A 25 to 30cm segment of bowel is isolated. The bowel is divided using the endoGIA stapler. The segment of ileum is opened on its antimesenteric side, and oriented in the shape of the letter “U.” Two arms of the letter “U” are sutured together to create the bowel patch. The dome of the bladder is opened, and the bowel patch is anastomosed to the bladder. The appendicovesicostomy is anastomosed to the bowel segment.

Results
This technique has been performed successfully in 19 patients with a median operative time of 275 minutes.

Conclusions
Robotic augmentation enterocystoplasty with catheterizable channel can be performed in completely incorporeal fashion.

Funding: None