NARUS 2018: Malone Creation at Time of Robotic Bladder Neck Reconstruction with Appendicovesicostomy
Methods
This was a retrospective review of all consecutive patients who underwent robotic creation of an APV and MACE with or without bladder neck reconstruction. Relevant pre-operative and post-operative data was collected. All patients were admitted preoperatively for mechanical bowel prep.
Results
A total of 6 patients underwent a complete robotic procedure. Out of the 6 patients, 4 had concurrent BNR with sling MACE Creation. 1 of the patients was left with 1cm appendix stump – lengthened by reconfiguring cecum with staples over catheter. 1 patient required tubularized cecal flap (appendix used entirely for APV). The authors reported no intraoperative or perioperative complications.
The results demonstrated that 3/6 patients were urine continent with CIC q2-4 hours. 2/6 patients underwent additional procedures for urinary incontinence: Deflux to APV channel, bladder Botox® injection, and APV stoma revision.
All patients were stool continent in between daily MACE flushes. No cases of stomal stenosis were reported.
Conclusions
The authors concluded that despite the fact that this is a very small series of patients with robotic assisted creation of APV and MACE, it does show that it is technically feasible in the pediatric population. Overall, there is encouraging short term results. However, long term follow up and larger patient series are needed.
Presented By: Christopher Brown, Nationwide Children’s Hospital, Ohio, USA
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV