Spiral Monti catheterisable continent channel performed by robot-assisted approach.

IF 2 3区医学 Q2 PEDIATRICS

Journal of Pediatric Urology Pub Date : 2025-03-21 DOI:10.1016/j.jpurol.2025.03.013

Filippo Ghidini, Clémence Klipfel, Stephan Geiss, Ciro Andolfi

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引用次数: 0

Abstract

Introduction: A catheterisable continent channel (CCC) is indicated in the treatment of neurogenic bladder. The most performed CCC is the Mitrofanoff's appendicovesicostomy. In case of unavailable cecal appendix, a Monti's ileovesicostomy, consisting in a tubularised ileal conduit, could be performed. This intervention benefits from the ergonomic advantages of robot-assisted laparoscopy.

Objective: We describe a case of a 25-year woman affected by neurogenic bladder consequent to a spina bifida.

Materials: A previous Mitrofanoff CCC failed due to ischemia of the conduit. The bladder voiding was managed by urethral self-catheterization and button cystostomy for several years. A spiral Monti CCC was planned. The intervention was performed by robot-assisted laparoscopic approach. Four robotic 8-mm robotic trocars and one 5-mm trocar were inserted in the umbilic, in both flanks and left hypochondrium respectively. A bowel segment was isolated and spirally shaped to obtain a sufficient length for the CCC.

Results: The length of surgery was 360 min, including docking time. The patient was discharged after two days. At 9-month follow-up, the channel is continent and catheterisable by a 16 Fr tube. No further episodes of UTIs or other complications were reported.

Conclusion: A complete intracorporeal approach was achieved thanks to the robotic platform.

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螺旋Monti导管大陆通道进行机器人辅助方法。

导言：可导尿的大陆通道（CCC）是指在治疗神经源性膀胱。执行最多的CCC是Mitrofanoff的阑尾膀胱造口术。在盲肠阑尾不可用的情况下，Monti的回肠造口术，包括一个管状的回肠导管，可以进行。这种干预得益于机器人辅助腹腔镜的人体工程学优势。目的：我们描述了一个25岁的妇女影响神经源性膀胱后脊柱裂。材料：先前的Mitrofanoff CCC由于导管缺血而失败。膀胱排尿采用自导尿和钮扣式膀胱造口术。一个螺旋形的蒙蒂CCC计划。干预通过机器人辅助腹腔镜入路进行。4个8毫米机器人套管针和1个5毫米机器人套管针分别插入脐部、两侧和左胁软骨。分离肠段并使其呈螺旋状以获得足够的长度。结果：手术时间为360 min，包括对接时间。病人两天后出院了。在9个月的随访中，通道畅通，可通过16fr管插管。没有进一步的uti发作或其他并发症的报道。结论：借助机器人平台，实现了完整的体内入路。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY

CiteScore

3.70

自引率

15.00%

发文量

330

审稿时长

4-8 weeks

期刊介绍： The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.