Ahmad, Andrabi, and Rathore describe a case where the stoma of an ileal conduit becomes edematous after laparoscopic cholecystectomy. As a result, urine flow was impaired and led to an acute renal failure superimposed on chronic renal insufficiency. Fortunately in this instance, the problem was recognized quickly and treatment was initiated which corrected and resolved the issue.

This case study increases our awareness of a potential complication of laparoscopic cholecystectomy and awareness is the first step toward prevention and/or treatment. Educating those in the health care field, including surgeons, nursing staff, and WOC nurses about this potential complication is important. In addition to the health care providers, a more focused preoperative and postoperative education program for the patient with an ileal conduit undergoing laparoscopic procedures appears warranted. The increasingly brief hospital stays for patients undergoing laparoscopic procedures with the short time under close observation of health care professionals makes this educational focus imperative. Topics for inclusion would be monitoring of urine output and close observation of stomal color and swelling, particularly in the first 24 to 48 hours after surgery. Patients then need to be able to state the action to be taken, that is, seeking immediate health care assistance if problems do occur. The use of a clear pouching system postoperatively will enable appropriate monitoring of the stoma mucosa. As suggested by the authors, preoperative insertion of an indwelling catheter into the stoma to ensure adequate urine outflow also may need to be considered.