Standardized Ileal Bladder Augmentation For Enterocystoplasty In Rats via Midline Laparotomy

Résumé fourni par la source

Bladder augmentation using intestinal segments remains a cornerstone reconstructive procedure for patients with low-capacity or poorly compliant bladders when conservative therapies fail. Despite its clinical relevance, experimental progress and in-depth study are limited by the lack of standardized, reproducible protocols that reliably model surgical principles in a controlled preclinical setting. Here, we present a step-by-step rat enterocystoplasty protocol that uses a vascularized, detubularized ileal patch as a pedicled flap to augment the native bladder. The procedure includes midline laparotomy, controlled exposure, and stabilization of the bladder with holding sutures, urinary diversion via an exteriorized cannula tube Foley, isolation of a short ileal segment with an intact mesenteric pedicle, detubularization, and tension-free anastomosis with the bladder wall. Emphasis is placed on maintaining mesenteric perfusion, preventing pedicle torsion, ensuring watertight suturing, and securing catheter patency, which are critical for procedural success and reproducibility. Representative intraoperative validation using hyperspectral imaging (HSI) in eight non-survival rats demonstrated preserved tissue oxygenation and perfusion of the bowel segment after key operative steps, supporting tissue viability at the end of this procedure. Thus, this protocol provides a standardized experimental approach for reproducible surgical implementation of rat enterocystoplasty. Potential downstream applications of the model include the investigation of metabolic and electrolyte alterations, infection susceptibility, mucus production, and induction of dysplasia or malignancy, and remain to be addressed in future survival investigations.

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