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Pediatric Robotic Assisted Laparoscopic Bladder Reconstruction

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Summary

Sometimes children with neurogenic bladder will need surgery to help them become dry or protect their kidneys from damage. These surgical procedures include:

  • An appendicovesicostomy - a surgery that uses the appendix to create a channel from the belly button or the lower abdomen to the bladder. A catheter is passed through this channel to empty the bladder.
  • A bladder neck reconstruction - a surgery that is performed on children who have urinary sphincters that don’t work well. This surgery tightens the urinary sphincter area to help resolve urinary leakage.
  • A bladder augmentation  - a surgery that is performed on children who have small bladders with high pressure. This surgery uses a piece of intestine to make a patch to put on the bladder to make it much larger.

All of these bladder reconstruction surgeries are major procedures that had always been performed through large incisions in the lower abdomen and required five- to seven-day hospital stays.

The Children’s Health Minimally Invasive and Robotic Surgery Center is one of few centers in the country that uses minimally invasive surgery for these complex conditions in children who are good candidates for this approach. That means that instead of one large incision, three to four incisions smaller than 1 cm are required. Potential advantages include decreased pain, decreased length of hospital stay and less scarring.

What to Expect

Your surgeon will provide specific information about what to expect depending upon the type of bladder reconstruction surgery your child needs. But in general:

  • Your child will be given anesthesia so he or she will sleep during the procedure.
  • Only a few small incisions will be necessary to complete the procedure.
  • Your child’s procedure could take between two and eight hours and you will be provided updates as the surgery progresses. You will be able to be with your child as soon as possible after the procedure.
  • Your child may have a tube in his or her nose for a few days while in the hospital after surgery. This tube helps your child’s stomach and bowels to heal after surgery. The tube will be removed before your child goes home.
  • Small tubes called catheters will be left in place after the surgery. These tubes will be removed at a follow-up appointment several weeks after your child is discharged. You will be shown how to care for those tubes before your child goes home from the hospital.
  • Your child will be discharged three to five days after surgery.

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