Antireflux Ureteroileal Anastmosis For Orthotopic Ileal Neobladder Using Wallace Technique In A Single Trough

Abstract

he construction of antireflux method for ureteroileal anastomosis in a low-pressure pouch is debatable and benefits should be weighted by probable morbidity. The perfect technique should be technically simple with no synthetic materials or very long segment of bowel. Split-cuff technique, Le Duc sulcus, submucosal tunneling and Kock procedure are accompanied with ureteric obstruction with resultant upper tract deterioration. The incidence is 3-5.3% in hemi-Kock pouch. In addition, studies of Le Duc mucosal sulcus showed widely varied results in regard to stricture and reflux rates and this variation was due to irregular creeping of the bowel mucosa over the embedded ureters.