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Chapter-32 Implantation—Ureteroneocystostomy Techniques

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Molmenti Ernesto P
2. Kayler Liise
3. Greenstein Stuart
ISBN
9789351523390
DOI
10.5005/jp/books/12547_33
Edition
1/e
Publishing Year
2015
Pages
6
Author Affiliations
1. Hofstra Northwell School of Medicine, Long Island, New York, USA, North Shore-LIJ Health System, Long Island, New York, USA; Hofstra North Shore–LIJ School of Medicine, Long Island, New York, USA
2. Montefiore Medical Center; Albert Einstein College of Medicine of Yeshiva University, New York, USA
3. Montefiore Medical Center; Albert Einstein College of Medicine of Yeshiva University, New York, New York, USA
Chapter keywords
leadbetter-politano ureteroneocystostomy, Lich-gregoir ureteroneocystostomy, U stitch ureteroneocystostomy, full-thickness ureteroneocystostomy, ureter, extravesical technique, anterior bladder

Abstract

This chapter discusses about ureteroneocystostomy techniques in kidney implantation, where this leadbetter-politano technique utilizes one cystostomy to access the interior of the bladder and another cystostomy to recreate a new ureteric orifice in a normal anatomic position. Insert a right angle clamp through the opening into the cavity of the bladder and through the superior posterior wall of the bladder. Use a clamp to backtrack through the submucosal plane, grasp the ureter, and pull it through the submucosal tunnel out the new hole. Lich-gregoir ureteroneocystostomy is an extravesical technique which consists of an anastomosis of the distal ureter to the bladder mucosa that is then buried in a muscular tunnel intended to provide a valve effect. In U stitch ureteroneocystostomy the ureter is spatulated, passed through the bladder opening, and the sutures taken out through the anterior bladder wall so that the ureteral end is anchored to the inner bladder wall.

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