Method of bladder augmentation with modified ileal segment and biologically compatible tissue

1. A method of augmenting a bladder of a subject comprising:

incising a native bladder along a sagittal plane between openings of two ureters in the native bladder to form an incised native bladder;

implanting a tissue flap comprising a nontubular bladder-expansion portion and a tubular portion into the incised native bladder; and

suturing the non-tubular portion of the bladder-expansion portion to an edge of the incised native bladder; and

anastomosing a distal end of the tubular portion of the tissue flap to the non-tailored end of each ureter;

wherein the tissue flap is an ileal segment that is modified by cutting along an antimesenteric border of a native ileal segment to form a cut ileal segment with a detubularized first end with two cut edges and a second end that forms the tubular portion;

wherein the method forms an augmented bladder with a volume capacity that is 100%-250% larger than a volume capacity of the native bladder; and

wherein said anastomosing comprises an end-to-end anastomosis of one ureter to the distal end of the tubular portion and a side-to-end anastomosis of the other ureter to the distal end of the tubular portion.

2. The method of claim 1 , further comprising detaching the two ureters from the native bladder after incising the native bladder and before implanting the tissue flap.

3. The method of claim 2 , further comprising trimming a ureteral stenotic segment of each ureter to form a non-tailored end of each ureter.

4. The method of claim 1 , wherein the tissue flap consists of an ileal segment that is 20-45 cm long and is taken from a distance of at least 10 cm from an ileocecal valve.

5. The method of claim 4 that further comprises:

isolating the ileal segment such that a segmental blood supply of the ileal segment is retained and the ileal segment has two ends; and

attaching a cut edge of the detubularized first end to itself to form the bladder-expansion portion of the tissue flap.

6. The method of claim 5 , wherein the ileal segment has a length 26 cm to 38 cm and is taken at a distance of at least 10 cm from an ileocecal valve.

7. The method of claim 5 , wherein the segment of the antimesenteric border of the ileal segment is 5 cm-8 cm in length.

8. The method of claim 1 , wherein the nontubular bladder-expansion portion is a curved structure comprising a lumen-exposed surface which faces an interior of the augmented bladder and a peritoneum-exposed surface which faces an exterior of the augmented bladder.

9. The method of claim 1 , wherein the tubular portion of the tissue flap has a hollow cylindrical shape with an interior radius of 5 mm-10 mm, an interior surface comprising a lumen-exposed surface, which is continuous with a lumen-exposed surface of the bladder-expansion portion, and an exterior surface comprising a peritoneum-exposed surface which is continuous with a peritoneum-exposed surface of the bladder-expansion portion.

10. The method of claim 9 , wherein the lumen-exposed surface of the bladder-expansion portion has a surface area of 25 cm 2 -45 cm 2 and the lumen-exposed surface of the interior surface of the tubular portion is 5 cm 2 -15 cm 2 .

11. The method of claim 1 , wherein the bladder expansion portion is sutured to an edge of the incised native bladder with absorbable sutures.

12. The method of claim 1 , wherein the subject is a child who has a neurogenic bladder.

13. The method of claim 1 , wherein the subject is a child who has a posterior urethral valve bladder disorder.

14. The method of claim 1 , wherein a proximal 5 cm of the ileal segment is kept as an afferent isoperistaltic tubularized loop.

15. The method of claim 1 , wherein a detubularized segment of the ileum is constructed as a U- or W-shaped patch.

16. The method of claim 1 , wherein the anastomosing a distal end of the tubular portion of the tissue flap to the non-tailored end of each ureter comprises an end-to-side anastomosis of a left ureter and an end-to-end anastomosis of a right ureter.

17. The method of claim 1 , wherein the tubular portion of the tissue flap is a hollow cylindrical shape that has an interior ranging from 5-10 mm and a lumen-exposed interior surface of 5-10 cm 2 .

18. The method of claim 1 , further comprising growing the tissue flap on a biocompatible scaffold.