Laparoscopic mitrofanoff appendicovesicostomy: Our experience in children

Abstract

Introduction: The Mitrofanoff principle was originally described as a method to provide an alternative means to access the bladder. It creates a conduit to the bladder through which patients with a sensitive, absent, or traumatized urethra can perform clean intermittent catheterization (CIC) easily. We report our experience with complete laparoscopic Mitrofanoff appendicovesicostomy to promote a catheterizable abdominal stoma. Materials and Methods: A 4-port transperitoneal approach was used to create a complete laparoscopic Mitrofanoff appendicovesicostomy. Results: Six children with a mean age of 12.8 years (range 9-16 years) underwent laparoscopic Mitrofanoff appendicovesicostomy. Mean operative time was 139.6 min and Mean estimated blood loss was 46 cc. No cases of urinary leaks were noted. There have been no cases of either stomal stenosis or appendicovesical stenosis noted. Conclusions: Pure laparoscopic Mitrofanoff appendicovesicostomy is feasible and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis.

Keywords

• Laparoscopy
• mitrofanoff
• surgical stoma
• urinary diversion