ArticleInvestigative and clinical urology2026
"Gundeti's 10 step modification" to the contemporary robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA) and the long-term outcomes.
Article in Investigative and clinical urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe robotic-assisted laparoscopic approach for creation of an appendicovesicostomy is in common practice now. We describe our modifications ("Gundeti's 10 step modification") to the conventional open technique for adopting the robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA), and study our long-term outcomes. MATERIALS AND
methodsThis was a retrospective review of prospectively collected data and electronic medical record review from 2008 to 2023. Children with failure to empty the bladder with normal bladder capacity who underwent RALMA incorporating our "Gundeti's 10 step modification" were included. The demographic, clinical, and postoperative details were analyzed. All were followed up annually, to monitor the continence and redo surgery rates. Success was defined as postoperative stomal continence and failure was considered in those who underwent redo procedures.
resultsTwenty-seven children were included with a mean age of 9.4 years. The mean hospitalization, estimated blood loss, and operative time were 5.27 days, 18.05 mL, and 236 minutes. The complications were suprafascial stenosis (11.1%), subfascial stenosis (3.7%), and channel incontinence (7.4%). Three children required redo procedures (11.1%). The mean follow-up was 69.41 months, and all 27 children are continent at the last follow-up (100.0%).
conclusionsOur proposed modifications, i.e., "Gundeti's 10 step modification" allows a success rate of 92.6% for continence and 89.0% based on redo surgery rates, thereby proving it to be a safe and feasible option amongst the paediatric population.
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