Laparoscopic Stapled Bladder Closure: Laboratory and Clinical Experience

Kerbl, Kurt; Chandhoke, Paramjit S.; McDougall, Elspeth M.; Figenshau, R. Sherburne; Stone, A.; Clayman, Ralph V.

doi:10.1016/s0022-5347(17)36408-x

Cited by 46 publications

(16 citation statements)

References 20 publications

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“…While these types of stapling devices have gained widespread acceptance and appear to be remarkably safe and free of complications [1,[3][4][5][6][7]11], this demonstrates that the possibility of morbidity exists with these devices. We are unaware of any other reports of free intraperitoneal wire staples causing problems.…”

Section: Resultsmentioning

confidence: 99%

Retained staples as a cause of mechanical small-bowel obstruction

Huntington

Klomp

1995

Surg Endosc

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The use of mechanical stapling devices in endoscopic surgery has become widespread and commonplace. Although problems have been identified with these, to our knowledge no description has been made of retained, free intraperitoneal staples causing significant morbidity. We describe the case of a patient who underwent laparoscopically assisted vaginal hysterectomy. Four weeks postoperatively she developed a mechanical small-bowel obstruction which was caused by a free intraperitoneal staple creating an obstructing band. The obstruction was relieved laparoscopically. We believe that while retained free intraperitoneal staples are generally of no clinical consequence, surgeons should be aware that the potential exists for significant morbidity.

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Section: Resultsmentioning

confidence: 99%

Retained staples as a cause of mechanical small-bowel obstruction

Huntington

Klomp

1995

Surg Endosc

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“…Since 1993 urologists also began using stapling devices for laparoscopic bladder closure (1,2). Kerbl et al performed laboratory and clinical studies and reported no intraand postoperative complications, with no episodes of stone formation 3-5 months after operation (1). However, at that time, these authors warned that previous experience with stainless steel staples in ileal loop diversion and Kock pouch had shown stone occurrence in 1.8-10% and in 16.7% of the patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first report of successful laboratory and clinical data of stapled bladder closure with titanium staples (1), several studies have adopted this technique with encouraging results (2)(3)(4)(5)(6). This technique possesses several advantages, such as decreased operative time, excellent tissue adaptation and presumably watertight closure.…”

Section: Introductionmentioning

confidence: 99%

“…This technique possesses several advantages, such as decreased operative time, excellent tissue adaptation and presumably watertight closure. However, the possibility of urinary stone formation on the staples requires long term follow--up (1). In this study we describe our technique for W-shaped orthotopic ileal pouch construction with non-absorbable titanium staples and report the results of long term follow-up.…”

Section: Introductionmentioning

confidence: 99%

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605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Kravchick¹,

Lobic²,

Paz³

et al. 2012

European Urology Supplements

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Purposes:We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non -absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. Materials and Methods:We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009. A 65-70 cm segment of ileum was isolated and prearranged into a W-configuration, leaving two 10 cm intact segments on both sides of the ileal fragment. In our technique we entirely anatomized all adjacent limbs in order to create a sphere-shaped pouch. The ureters were directly anastomized to both intact segments of the ileal division. All our patients underwent pouchscopy 6 months after operation and annually. Results: Mean operative time for neobladder reconstruction and ureteral anastomoses was 87 ± 7.67 minutes. In one patient a leak from the ileo-ileal anastomosis was confirmed on the 3rd day after operation. In 2 cases unilateral stricture of the ureteral-neobladder anastomosis was documented. Staple lines were mostly covered with ileal mucosa after 6 months. The mean functional bladder capacity was 340 ± 27.6 mL and 375 ± 43.4 mL at 6 and 12 months, respectively. First-year daytime and nighttime continence was good and acceptable in 90% and 78% of patients, while it increased to 95% during the 2nd year. Conclusions: The long term follow-up shows that non-absorbable titanium staples can be safely used for creation of an orthotopic ileal neobladder. However, these data should be further validated in a larger series of patients.

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“…The automatic suturing device [4,10] we used was of considerable help to reduce the dura tion of surgery. It has been suggested that titanium staples may be an alternative technique to quickly close bladder defects [12], However, such staples should not be used, as it cannot be excluded that they are lithogenic in the long run [12], The automatic suturing devices at disposal presently should encourage the surgeon facing an intraperitoneal bladder rupture to try a laparoscopic repair.…”

Section: Discussionmentioning

confidence: 99%