Dr. Sean Elliott, MD
Reconstructive Urologist
CCIC: Continent Catheterizable Ileal Cecocystoplasty
Final outcome of bladder augment and catheterizable channel/stoma.
A CCIC is one way of creating a bladder augmentation and a catheterizable stoma at the same time. It uses the first part of the colon for the bladder augmentation and the last part of the small intestine for the catheterizable stoma. An alternative to a CCIC would be to use the appendix for the stoma and the small intestine for the bladder augmentation. Different operations work better for different people. Your surgeon can help you decide which is best for you.
Kidneys
Ureters
Figure 1.
Figure 2. Intestine is cut twice to isolate segment for augmentation and channel.
Food/stool coming from stomach
Food/stool going toward rectum
Colon/large intestine
Small intestine
10 cm
10 cm
Figure 3. Augment/channel segment is removed from rest of intestine.
Colon/large intestine
Small intestine
Figure 4. The two ends of the intestine are reconnected.
Colon/large intestine
Small intestine
Food/stool going toward rectum
Food/stool coming from stomach
Figure 5. A pouch is created from isolated segment of intestine. The intestine is washed out and the colon portion is opened lengthwise.
Figure 6. The colon is opened wide (the inside of the colon is shown in pink). The small intestine is narrowed to the size of a catheter by cutting out some of its diameter and then sewing it closed lengthwise. The valve between small intestine and colon is shown as small brown circle.
Natural valve to make pouch “continent”
Figure 7. The bladder is opened and the augment is rotated counter-clockwise to bring the catheterizable stoma to the top.
Figure 8. The augment is brought down to the bladder.
Figure 9. The bottom of the augment is sutured to the back wall of the bladder.
Natural valve to make pouch “continent”
Bring stoma out through abdominal wall, usually at the belly button
Figure 10. The bottom of the augment is sutured to the back wall of the bladder.
Figure 11. The top of the augment is sutured to the front wall of the bladder.
Figure 12. The final outcome of bladder augment and catheterizable channel/stoma.
Kidneys
Ureters