Nissen-type colonic bladder wall ureteral wraparound for reimplantation in a complex reconstructive case.
We have applied a technique patterned after the Nissen gastroesophageal fundoplication to accomplish an antireflux mechanism in a girl who had had several failed operations that left her with a microbladder augmented with colon and both ureters replaced by small bowel and implanted without any antireflux procedure. Anchoring of the wrapped colonic bladder wall to the ureteral musculature and the addition of a psoas hitch were important in assuring the success of the procedure. This technique can be utilized in similar cases as a tool to prevent reflux and avoid the need for more complex surgical treatment.
Dr. Domingo Luciani Hospital and the Tamanaco Urologic Institute, Caracas, Venezuela.
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Pieretti
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Pieretti-Vanmarcke