Laparoscopy assisted versus open ileocystoplasty in pigs.
OBJECTIVE
We compared laparoscopy assisted and open ileocystoplasty in an experimental model in pigs. We evaluated intraoperative aspects, postoperative recovery, peritoneal adhesions and functional results.


METHODS
The study included 30 male pigs divided into 4 groups, including 10 with laparoscopy assisted ileocystoplasty, 10 with open surgery, 5 with sham laparoscopy and 5 with sham open surgery. Variables studied were total operative time, ileovesical anastomosis time, postoperative urodynamic findings (bladder capacity and compliance), daily and weekly weight gain, and intraperitoneal adhesions (incidence, type and score).


RESULTS
Mean operative time in the laparoscopic and open groups was 179.4 and 69.6 minutes, respectively, which was significantly different (p <0.05). Mean ileovesical anastomosis time was also significantly different for laparoscopic vs open surgery (74.8 vs 31.8 minutes, p <0.05). Significant differences were observed in mean weekly weight gain during the first 4 weeks after surgery. Postoperatively bladder capacity and compliance differences among the groups were not significantly different (p >0.05). The overall incidence of intraperitoneal adhesions was not significantly different in all groups (p >0.05). However, in the open vs laparoscopy, sham laparoscopy and sham open surgery groups adhesion complexity was greater and mean score was higher (4.2 vs 2.8, 2.0 and 2.0, respectively), which was statistically significantly different (p <0.05).


CONCLUSIONS
Laparoscopy assisted ileocystoplasty requires more operative time than open surgery. However, postoperative recovery is more rapid and intraperitoneal adhesions are less complex in pigs with laparoscopy assisted ileocystoplasty vs conventional surgery. Functional results are comparable for open and laparoscopy assisted ileocystoplasty.
Lavoura
Nivaldo da Silva
Nda S
Department of Urology Santa Casa de Misericórdia Hospital of Piracicaba and Division of Urology, University of Campinas (CALDA, DS), Campinas, São Paulo, Brazil. nlavoura@terra.com.br
D'Ancona
Carlos Arthuro Levi
CA
Neves
Francisco de Castro
Fde C
Borges
Gustavo M
GM
Silva
Daniel
D
D000818:Animals; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D013552:Swine; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods