Video-assisted colonic conduit: a new minimally invasive urinary diversion to patients after pelvic radiotherapy.

PURPOSE: To report preliminary results of the first case of video-assisted colonic conduit. A 42-year-old woman had undergone external beam radiotherapy for squamous cell carcinoma of the cervix and developed a vesicovaginal fistula with small capacity bladder. Intraoperative option for urinary diversion was colonic conduit.

METHODS

A 4 trocar transperitoneal approach was chosen and isolation of both ureters was performed. A 5 cm incision between xiphoid and umbilicus was carried out. A 15 cm colonic segment was isolated with linear stapler maintaining blood supply. Intestinal transit was then reconstructed. Leadbetter ureterointestinal anastomoses were performed with ureteral splints. Drainage, colostomy maturation, and closure of incisions were carried out conventionally.

RESULTS

Operative time was 195 minutes; blood loss was 90 mL; no intraoperative or postoperative complications were observed. Length of hospital stay was 7 days and time to full recovery 3 weeks.

CONCLUSIONS

Video-assisted colonic conduit is feasible and have promising results concerning reduction of surgical morbidity.