Video-assisted colonic conduit: a new minimally invasive urinary diversion to patients after pelvic radiotherapy.
OBJECTIVE
To report preliminary results of the first case of video-assisted colonic conduit. A 42-year-old woman had undergone external beam radiotherapy for squamous cell carcinoma of the cervix and developed a vesicovaginal fistula with small capacity bladder. Intraoperative option for urinary diversion was colonic conduit.


METHODS
A 4 trocar transperitoneal approach was chosen and isolation of both ureters was performed. A 5 cm incision between xiphoid and umbilicus was carried out. A 15 cm colonic segment was isolated with linear stapler maintaining blood supply. Intestinal transit was then reconstructed. Leadbetter ureterointestinal anastomoses were performed with ureteral splints. Drainage, colostomy maturation, and closure of incisions were carried out conventionally.


RESULTS
Operative time was 195 minutes; blood loss was 90 mL; no intraoperative or postoperative complications were observed. Length of hospital stay was 7 days and time to full recovery 3 weeks.


CONCLUSIONS
Video-assisted colonic conduit is feasible and have promising results concerning reduction of surgical morbidity.
Tobias-Machado
Marcos
M
Department of Urology, ABC Medical School, São Paulo, Brazil. tobias-machado@uol.com.br
Starling
Eduardo Simao
ES
Korkes
Fernando
F
da Silva
Matheus Neves Ribeiro
MN
Appolonio
Paulo Roberto
PR
Wroclawski
Eric Roger
ER
D000328:Adult; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D010388:Pelvis; D011832:Radiation Injuries / Q000150:complications; D017792:Surgical Stapling; D014513:Ureter / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000601:surgery*; D020535:Video-Assisted Surgery