Endovideosurgical interventions in the bladder diverticulum in children

Abstract

Introduction. Among congenital and acquired malformations in the urinary system organs, one of the topical issues is the choice of management modalities in bladder diverticulum. Modern equipment and development of minimally invasive techniques have expanded the variability of curative approaches, which is especially important for children with comorbidities.Purpose. To optimize surgical treatment of children with bladder diverticulum using minimally invasive surgical interventions, to reduce the rate of intraoperative and postoperative complications as well as to improve endovideosurgical access for the successful implementation of reconstructive interventions based on the authors' analysis of their own material on treating children with bladder diverticula.Material and methods. Five patients of different age having a bladder diverticulum with various anatomical features and with comorbidities were treated at the surgical department of St. Luka Clinical Research Specialized Center for Children (Moscow, Russia) in 2021–2022. The researchers could find the principle for selecting a proper surgical modality after they had assessed positive and negative aspects of each type of surgical access.Results. While choosing the type of surgical access in the discussed patients, the authors took into account anatomical features, concomitant pathologies, findings of instrumental diagnostics. As a result, all patients had good outcomes. The authors demonstrated a successful application of endovideosurgical techniques in the management of patients with congenital bladder diverticula after they had analyzed their own clinical material. They also described effective techniques for reconstructing ureterovesical anastomosis area with consideration of its place in relation to the diverticulum.Conclusion. The pneumovesicoscopic access for congenital bladder diverticulum removal is the most rational one, as it allows to accurately restore the relationship of anatomical structures.