Technique of total robotic augmentation gastrocystoplasty

Abstract

Objective: To demonstrate the execution of augmentation gastrocystoplasty in a total robotic approach. Materials: A 27-year-old lady presented with a fibrotic and contracted urinary bladder secondary to ketamine abuse. Her impaired renal function rendered her unfit for ileo-cystoplasty. Robotic augmentation gastrocystoplasty was performed, beginning with the stomach part in a head-up position. 10 cm wedge of stomach was used as the patch to augment the bladder, preserving the right gastro-epiploic vessel as its blood supply. The bladder part was completed with redocking of the robot and putting the patient in a slight Trendelenburg position. Upon completion of the procedure, the patient had a urethral Foley catheter and a pelvic drain in place. The whole procedure was performed by the urology team. Results: Operation time was 275 min. Blood loss was 100 ml. Nasogastric tube was taken off on post-op day 2. The patient was discharged on post-op day 6. Foley was taken off on post-op day 14. Recovery course was smooth without complication. At 1 year, functional bladder capacity was 330 ml. The patient's renal function remained static. Conclusions: Total robotic augmentation gastrocystoplasty is a safe alternative to the conventional open approach. Long term outcome assessment is necessary to determine if this minimal invasive approach can be recommended as one of the standard options in this setting.

Keywords

• Augmentation cystoplasty
• Cystitis
• Reconstruction