A new method for endoscopic repair of bladder neck stenosis with buccal mucosa after a prostatectomy.

The proposed project is a continuation of the master's thesis by Stijn Claus (academic year 2023-2024), in which a surgical instrument (EndoComb) was developed to aid in the treatment of bladder neck stenosis. Prostate cancer is one of the most common types of cancer worldwide. To treat the cancer, the entire prostate is often removed (radical prostatectomy). After this procedure, there is a risk of bladder neck narrowing due to scar tissue formation (bladder neck stenosis). This narrowing needs to be surgically removed to restore normal function. The current method to remove this narrowing is highly invasive and often leads to incontinence and impotence. Prof. Dr. Gunter De Win developed a new surgical technique that reduces these side effects. The aim of the master's thesis was to further optimize this surgical technique, which resulted in the development of the EndoComb. EndoComb is essentially an extension that can be used in combination with a tacker (fixation instrument) and an endoscope (camera). The extension facilitates the insertion, positioning, and fixation of buccal mucosa. Buccal mucosa is used to repair the urethra, which is damaged following the complete removal of the prostate. EndoComb offers a significant advantage over current methods because it eliminates the need for incisions. The entire operation can be performed in a non-invasive, endoscopic manner. The IOF POC project follows a four-phase process. In the first phase, the concept is further developed and verified through benchmark testing, using a urethra model that closely mimics reality. These tests are conducted with Lo-fi prototypes created through 3D printing. In the second phase, these prototypes are refined for accurate usability testing, potentially extending to cadaver tests. The third phase involves cadaver testing with Hi-fi prototypes, manufactured using materials like stainless steel or polyoxymethylene. In the final phase, the model is further improved based on the results from the previous phase and used for additional cadaver tests. A potential collaboration with the Swiss company Regenosca is being explored. Regenosca specializes in creating artificial grafts, and their product can be perfectly combined with EndoComb.

Keywords:BLADDER, PROSTATECTONOMY, BLADDER SURGERY

Disciplines:Tissue engineering, Urological surgery, Urology, Medical device usage