W-Stapled Ileal Neo-Bladder Formed Entirely with Absorbable Staples

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Abstract
Orthotopic bladder replacement after total cystoprostatectomy for bladder cancer has gained broader use. Continent diversion has historically increased the complexity of the surgical procedure, often discouraging its adoption by many urologists. Absorbable staples on a GIA* instrument became available in 1992 and have been incorporated into reservoir formation in this preliminary study. A novel W-shaped ileal reservoir entirely fashioned from absorbable staples using the GIA and TA instruments has been developed and used in 15 patients undergoing cystoprostatectomy. The advantages of this technique are its simplicity and the speed with which the reservoir can be fashioned. In the first 15 patients operative time to construct the reservoir ranged from 12 to 21 minutes. Functional aspects of urodynamic studies and continence appear comparable to those of other ileal reservoirs. These preliminary data justify comparative trials on an expanded scale.