(NDP120) A case report of Robotic assisted laparoscopic radical cystectomy with Y pouch orthotopic ileal neobladder constructed using nonabsorbable endo GIA staples
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  • 2015-06-18,
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達文西輔助腹腔鏡膀胱根除術併使用內視鏡切割縫合器縫合Y型人工新膀胱
病例報告與文獻回顧
李郁俐1,2、賴昱維1,2 、薛又仁1,2、 黃建榮1, 2 、邱逸淳1,2 、陳修聖1,2、 邱文祥1,2
台北市立聯合醫院外科部泌尿外科1
國立陽明大學醫學院泌尿學科2
A case report of Robotic assisted laparoscopic radical cystectomy with Y pouch orthotopic ileal neobladder constructed using nonabsorbable endo GIA staples
Yuli Lee、Lipin Chiu、Yuwei Lai、Thomas Y. Hsueh、Yi-Chun Chiu、Shiou-Sheng Chen、Allen W. Chiu
Divisions of Urology, Department of Surgery, Taipei City Hospital, Taiwan
National Yang-Ming University, School of Medicine, Taiwan
BACKGROUND:
Laparoscopic-assisted radical cystectomy with Y pouch orthotopic ileal neobladder constructed using nonabsorbable titanium staples was early reported in 2006. Herein we present the case of robotic assisted laparoscopic radical cystectomy with Y pouch orthotopic ileal neobladder constructed using nonabsorbable endo GIA staples and a brief literature review.
CASE REPORT:
A 65-year-old man was admited because of pianless gross hematuria. Cystoscopy showed multiple focal cauliflower tumor. Transurethral resection of bladder tumor was performed. The pathological report showed urothelial carcinoma with muscle invasion. Computed tomography showed diffuse bladder wall thickness and no obvious lymph node metastasis. We performed robotic assisted laparoscopic radical cystectomy with U-shaped orthotopic ileal neobladder constructed using nonabsorbable endo GIA staples . In our procedure, a 50-cm ileal segment is arranged in a U shape with two segments of approximately 20 cm and two afferent limb of 5 cm. An opening is made at the lowest point of the U-ileal segment on its antimesenteric border. The jaws of the endoGIA stapler are accommodated within the bowel loop and fired as low as possible, bringing together and detubularizing of each arm of the U. To complete the pouch detubularization, another small opening is made at the bottom. Then use the endo GIA, completing the U pouch. Then performed the anastomosis of The open ends of the U shape and the cutting end of urethra.Total operation time is 290 minutes and no intraoperative complication. The patient was discharged uneventfully. Post operation one year follow-up, no bladder stone and no renal function deterioration were noted
CONCLUSION:
Robotic assisted laparoscopic radical cystectomy with U-shaped orthotopic ileal neobladder constructed using nonabsorbable endo GIA staples seem a feasible, safe and rapid procedure.
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    發表時間 :
    2015-06-18 21:12:00
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    2,104
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    TUA秘書處1
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    台灣泌尿科醫學會
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