Laparoscopic Bladder Augmentation: State of the Art

Abstract

The application of laparoscopic techniques to urinary tract reconstruction is in its infancy. We have seen an evolution over the past 5 years from large midline incisions for nearly all reconstructive bladder operations to minimal lower abdominal incisions for even the most complex reconstructive procedures. The techniques used for laparoscopic bladder augmentation have included autoaugmentation or detrusorrhaphy, gastrocystoplasty, and laparoscopy-assisted techniques when the majority of the reconstruction is done through a small open incision. Newer techniques for bladder enlargement, including the use of cultured tissue or exogenous tissue scaffolding, might be performed laparoscopically in a relatively straightforward manner. There is little doubt that the standard of care for bladder augmentation and other urinary tract reconstructive procedures will shift to minimally invasive approaches over the coming decade.