V13-07 PROPHYLACTIC MESH PLACEMENT AT TIME OF ILEAL CONDUIT CREATION: A SIMPLE SUBLAY TECHNIQUE

Abstract

You have accessJournal of UrologyBladder & Upper Tract Urothelial Oncology (V13)1 Sep 2021V13-07 PROPHYLACTIC MESH PLACEMENT AT TIME OF ILEAL CONDUIT CREATION: A SIMPLE SUBLAY TECHNIQUE Da David Jiang, Kyle Gillis, Kenneth Softness, Nicholas Chakiryan, Alison Levy, Vitaliy Poylin, Andrew Wagner, and Peter Chang Da David JiangDa David Jiang More articles by this author , Kyle GillisKyle Gillis More articles by this author , Kenneth SoftnessKenneth Softness More articles by this author , Nicholas ChakiryanNicholas Chakiryan More articles by this author , Alison LevyAlison Levy More articles by this author , Vitaliy PoylinVitaliy Poylin More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , and Peter ChangPeter Chang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002100.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A prospective randomized study of prophylactic mesh placement at the time of cystectomy and ileal conduit found a significant reduction the cumulative incidence of parastomal hernias by approximately 50%.We present a novel simple sutureless prophylactic sublay permanent mesh placement at the time of ileal conduit creation. METHODS: Bard VentralightTM ST mesh is a permanent medium weight monofilament propylene mesh. It has an absorbable hydrogel barrier on the posterior side based on Sepraâ Technology (ST). A circular mesh with 6cm in diameter is formed; a cruciate cut is made centrally. The space between the posterior sheath and the rectus is bluntly dissected circumferentially. The conduit is brought out of the stoma site and the mesh is thread over the conduit with the shiny ST side down; the ST side is in contact with the conduit and prevents adhesions. The mesh is then gently tucked into the dissected space. The rest of the conduit is matured in standard fashion. RESULTS: We first placed prophylactic mesh in this fashion in 3/2019; since 8/2020, we perform this technique on every ileal conduit diversion. To date, 38 cases have been done; 34 via robotic intracorporeal diversion. Median follow up is 4 months (IQR 2-8). There have been no mesh-related complications such as mesh erosion, mesh infection, mesh pain, or need for mesh explant. The follow-up is too short to determine efficacy, but no clinically apparent parastomal hernias have developed. 21 patients had postoperative imaging with a median radiographic follow-up of 5 months (IQR 3-10); of these, 1 patient (5%) had radiographic evidence of a parastomal hernia. CONCLUSIONS: We present a novel simple sutureless technique for prophylactic mesh placement at time of ileal conduit creation. With short follow-up, there are no evidence of mesh-related complications. Longer follow-up is needed to determine efficacy. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1080-e1080 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Da David Jiang More articles by this author Kyle Gillis More articles by this author Kenneth Softness More articles by this author Nicholas Chakiryan More articles by this author Alison Levy More articles by this author Vitaliy Poylin More articles by this author Andrew Wagner More articles by this author Peter Chang More articles by this author Expand All Advertisement Loading ...