I applied robotic augmentation ileocystoplasty to 11 patients I followed up for neurogenic bladder. Studies with long-term follow-up are needed to compare the success rate and advantages compared to open surgery. However, the experience in the literature is still limited and there are few series and case reports. Robotic surgery, which has become popular in recent years, has shortened the rather long learning curves of laparoscopic operations. In this procedure, the intestines are used to enlarge the bladder. Robotic bladder augmentation: Some children may have very small bladders that store urine.These procedures help prevent urine leakage from the bladder. Robotic bladder neck reconstruction/ bladder neck suspension procedures: In some children, the structure called the urinary sphincter, which keeps the urine in the bladder, does not work normally.Robotic appendicovesicostomy: In this method, also known as the Mitrofanoff procedure, the child's appendix is mouthed between the bladder and the abdominal skin, and after urine accumulation in the urinary bladder, the child can evacuate by catheterization through the hole in the abdominal skin.I offer the following minimally invasive surgical options to families in neurogenic bladder problems: What are the minimal invasive surgery options in neurogenic bladder problems? Approximately 40 cm of small intestine is taken, opened, and reshaped to protect the vessels and used to enlarge the bladder. The use of laparoscopy in such an operation has taken a long time because of the length of the learning curve and potential complications.įigure 1: Bladder augmentation technique. Classically, it is necessary to make large abdominal incisions to solve these problems. If damage to the kidneys by VUR and infection is not prevented, high blood pressure or kidney failure may develop over time.īladder augmentation, which is surgery in which the bladder is enlarged using the bowel it is a preferred surgical approach in patients with high intravesical pressure but low bladder capacity, despite frequently clean intermittent catheterization and drug treatments that prevent bladder contraction (figure 1). When urinary tract infection and VUR come together, the infected urine reaches the kidneys and causes an infection of the kidneys called pyelonephritis. High pressure storage of urine in the bladder or discharge of urine causes the urine to flow back from the bladder to the kidneys, called vesicoureteral reflux (VUR). Keeping the bladder full makes it difficult to pass urine from the kidneys to the bladder, causing the ureters and kidneys to expand and disrupt their work. Therefore, urinary tract infection is common in children with neurogenic bladder. If the bladder is not able to empty the urine completely, the residual urine remaining inside becomes infected easily. What is the importance of neurogenic bladder? When urinating, the pressure inside the bladder may become too high and it may not be possible to hold the urine. When these nerves that control the functioning of the bladder are affected, urinary bladder dysfunction, which we call neurogenic bladder, occurs. These nerves may be affected due to congenital diseases such as meningomyelocele developing in this region or trauma or surgery to the lumbar region. Nerves controlling the bladder exit from the waist. Robot in Neurogenic Bladder Robotic Appendicovesicostomy, Robotic Bladder Neck Reconstruction, Robotic Bladder Neck Suspension, Robotic Bladder Augmentation, Robotic Augmentation Ileocystoplasty
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