title: Completely intracorporeal robotic-assisted laparoscopic augmentation enterocystoplasty with continent catheterizable channel.
abstract: OBJECTIVE
  To report our results from series of robotic-assisted laparoscopic augmentation enterocystoplasty (RALAE) performed in a completely intracorporeal fashion.
  
  
  METHODS
  Patients who underwent RALAE with or without the creation of a catheterizable channel between 2006 and 2011 at the University of Texas, Houston and Northwestern Memorial Hospital were identified. Perioperative and follow-up data were analyzed. Preoperative and postoperative urodynamic data were analyzed when available.
  
  
  RESULTS
  Twenty-two patients with neurogenic bladder underwent RALAE with or without the creation of a catheterizable channel. Fifteen patients underwent robotic augmentation enterocystoplasty alone, and 7 patients had creation of a catheterizable channel (4 Monti and 3 Mitrofanoff). There was 1 conversion to an open procedure in a patient undergoing concomitant creation of an appendicovesicostomy. Mean follow-up was 38.9 months (range, 6.2-72.1 months). Mean operative time was 365 minutes (range, 220-788 minutes); mean estimated blood loss was 110 mL (range, 30-250 mL). Median time to return of bowel function was 5 days (range, 2-17 days). Preoperative and postoperative urodynamic data were available for 13 patients. Mean cystometric capacity increased by 52%, and mean maximal bladder pressures decreased by 40. There were 5 minor complications (Clavien grade 1-2) and 4 major complications (Clavien grade 3-4). No patient experienced a wound infection.
  
  
  CONCLUSIONS
  RALAE is a feasible approach that provides potential benefits over open bladder reconstruction in the neurogenic voiding dysfunction population.
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: Andrew-Flum@northwestern.edu.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Flum
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, NY.
authors.forename: Lee C
authors.initials: LC
authors.lastname: Zhao
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Kielb
authors.affiliation: Department of Surgery, University of Texas Medical School, Houston, TX.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Wilson
authors.affiliation: Vanguard Urologic Institute, Memorial Hermann Texas Medical Center, Houston, TX.
authors.forename: Tung
authors.initials: T
authors.lastname: Shu
authors.affiliation: Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: John C
authors.initials: JC
authors.lastname: Hairston
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000601:surgery*; D014546:Urinary Catheterization; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics