Continent ileal pouch using the serous-lined principle.
OBJECTIVE
The flap valve principle is not easily applicable to an ileal pouch since a submucosal tunnel is difficult to create. We attempted to construct an ileal pouch with an umbilical stoma applying the serous-lined principle for both ureteral implantation and construction of a continent valve.


METHODS
In 9 patients, a continent pouch with an umbilical stoma was created entirely from an ileal segment. Adopting the serous-lined principle, a continent valve was created by appendix in 2 cases, tapered ileum in 3 cases, and reconfigured ileum in 4 cases. These were implanted into the anterior suture line of the pouch and embedded into the serous-lined tunnel formed by the pouch wall.


RESULTS
Patients can catheterize the pouch easily with a 14-Fr catheter. Postoperatively, pouch capacity is over 400 ml with complete continence.


CONCLUSIONS
This technique can provide a simple and effective continent ileal pouch facilitating umbilical anastomosis. As a continent valve, the reconfigured ileal segment seems most useful for application of the serous-lined principle.
Kato
H
H
Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan. kart@hsp.md.shinshu-u.ac.jp
Igawa
Y
Y
Kiyokawa
H
H
Iwata
K
K
Nishizawa
O
O
D005500:Follow-Up Studies; D006801:Humans; D012704:Serous Membrane; D013524:Surgical Flaps; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000379:methods