Pediatric Continent Reservoirs and Colocystoplasty Created with Absorbable Staples

Abstract

Purpose For patients undergoing continent urinary diversion or bladder augmentation the process of detubularization and refashioning bowel into a spherical configuration is often tedious and time-consuming, and may cause undesirable blood loss. We sought to determine whether using absorbable staples in a pediatric population was safe, effective and economical. Materials and Methods We performed our technique of rapid right colon pouch construction in 18 children (average age 12.3 years) undergoing continent urinary diversion (8) or colocystoplasty (10). We evaluated the cost of performing the procedure relative to conventional suturing as well as the results of up to 3 years of followup. Results In all cases pouch construction using absorbable staples was performed easily and rapidly, and resulted in minimal blood loss. Using the staples decreased operative time by approximately 1 hour and saved nearly $350 per case. Only 1 significant complication requiring surgical intervention developed during extended followup (delayed pouch rupture) and in that case the use of absorbable staples did not contribute to morbidity. None of the patients had reservoir stones. Conclusions The use of devices applying absorbable staples in conjunction with a 1-step method of colonic reservoir construction proves to be effective and economically sound for continent urinary diversion and bladder augmentation.