Ileal ureter creation for long-segment ureteral injury – A surgical film
Objective: Demonstrate surgical steps of ileal ureter creation (IUC) for long-segment ureteral injury. Methods: 79-year-old woman with platinum-sensitive ovarian cancer with recurrence to upper vagina who underwent secondary debulking surgery with ureteral transection due to disease involvement and...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925000268 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850147284371636224 |
|---|---|
| author | Christine McGough Maya Fisher Samuel Lentz Laurel Berry |
| author_facet | Christine McGough Maya Fisher Samuel Lentz Laurel Berry |
| author_sort | Christine McGough |
| collection | DOAJ |
| description | Objective: Demonstrate surgical steps of ileal ureter creation (IUC) for long-segment ureteral injury. Methods: 79-year-old woman with platinum-sensitive ovarian cancer with recurrence to upper vagina who underwent secondary debulking surgery with ureteral transection due to disease involvement and subsequent placement of percutaneous nephrostomy tube. She responded well to adjuvant chemotherapy and PARP inhibitor maintenance and presented for ureteral reconstruction surgery. Results: This video demonstrates surgical technique for IUC. An isoperistaltic ileal segment is used, ensuring adequate blood supply and tension-free anastomosis. The ureter was spatulated and sutured in full-thickness fashion to a small defect created in the chosen segment of ileum. A double-J ureteral stent was placed into the renal pelvis over a guidewire and a defect was made in bladder dome for ileal ureter implantation. Conclusions: Ileal ureter creation (IUC) was first described in 1906 by Shoemaker and later popularized by Goodwin et al in the 1950 s (Goodwin et al., 1959). IUC has been shown in large case series to have a success rate of 69 to 96 %, however is associated with 29.8 to 42.9 % 30-day postoperative complication rate (Monn et al., 2018; Armatys et al., 2009; Zhong et al., 2019). Approximately 75 % of patients have stable serum creatinine after the procedure, however caution is advised in patients with baseline renal impairment (Armatys et al., 2009). IUC can be technically challenging as it involves a larger surgical field for harvesting a segment of bowel and is typically reserved for long-segment injuries deemed not amenable to alternate surgical methods (Armatys et al., 2009). In one study, overall long-term morbidity approximated 23 % therefore careful patient selection and adequate preoperative counseling is necessary (Armatys et al., 2009). |
| format | Article |
| id | doaj-art-e45848d8b3b344b487f58f4f94eb74bf |
| institution | OA Journals |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-e45848d8b3b344b487f58f4f94eb74bf2025-08-20T02:27:35ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810170110.1016/j.gore.2025.101701Ileal ureter creation for long-segment ureteral injury – A surgical filmChristine McGough0Maya Fisher1Samuel Lentz2Laurel Berry3Wake Forest University School of Medicine, Department of Obstetrics and Gynecology, Section on Gynecologic Oncology, Winston-Salem, NC, United States; Corresponding author.Wake Forest University, School of Medicine, Winston-Salem, NC, United StatesWake Forest University School of Medicine, Department of Obstetrics and Gynecology, Section on Gynecologic Oncology, Winston-Salem, NC, United StatesWake Forest University School of Medicine, Department of Obstetrics and Gynecology, Section on Gynecologic Oncology, Winston-Salem, NC, United StatesObjective: Demonstrate surgical steps of ileal ureter creation (IUC) for long-segment ureteral injury. Methods: 79-year-old woman with platinum-sensitive ovarian cancer with recurrence to upper vagina who underwent secondary debulking surgery with ureteral transection due to disease involvement and subsequent placement of percutaneous nephrostomy tube. She responded well to adjuvant chemotherapy and PARP inhibitor maintenance and presented for ureteral reconstruction surgery. Results: This video demonstrates surgical technique for IUC. An isoperistaltic ileal segment is used, ensuring adequate blood supply and tension-free anastomosis. The ureter was spatulated and sutured in full-thickness fashion to a small defect created in the chosen segment of ileum. A double-J ureteral stent was placed into the renal pelvis over a guidewire and a defect was made in bladder dome for ileal ureter implantation. Conclusions: Ileal ureter creation (IUC) was first described in 1906 by Shoemaker and later popularized by Goodwin et al in the 1950 s (Goodwin et al., 1959). IUC has been shown in large case series to have a success rate of 69 to 96 %, however is associated with 29.8 to 42.9 % 30-day postoperative complication rate (Monn et al., 2018; Armatys et al., 2009; Zhong et al., 2019). Approximately 75 % of patients have stable serum creatinine after the procedure, however caution is advised in patients with baseline renal impairment (Armatys et al., 2009). IUC can be technically challenging as it involves a larger surgical field for harvesting a segment of bowel and is typically reserved for long-segment injuries deemed not amenable to alternate surgical methods (Armatys et al., 2009). In one study, overall long-term morbidity approximated 23 % therefore careful patient selection and adequate preoperative counseling is necessary (Armatys et al., 2009).http://www.sciencedirect.com/science/article/pii/S2352578925000268Ileal ureterUreteral reconstructionUreteral injury |
| spellingShingle | Christine McGough Maya Fisher Samuel Lentz Laurel Berry Ileal ureter creation for long-segment ureteral injury – A surgical film Gynecologic Oncology Reports Ileal ureter Ureteral reconstruction Ureteral injury |
| title | Ileal ureter creation for long-segment ureteral injury – A surgical film |
| title_full | Ileal ureter creation for long-segment ureteral injury – A surgical film |
| title_fullStr | Ileal ureter creation for long-segment ureteral injury – A surgical film |
| title_full_unstemmed | Ileal ureter creation for long-segment ureteral injury – A surgical film |
| title_short | Ileal ureter creation for long-segment ureteral injury – A surgical film |
| title_sort | ileal ureter creation for long segment ureteral injury a surgical film |
| topic | Ileal ureter Ureteral reconstruction Ureteral injury |
| url | http://www.sciencedirect.com/science/article/pii/S2352578925000268 |
| work_keys_str_mv | AT christinemcgough ilealuretercreationforlongsegmentureteralinjuryasurgicalfilm AT mayafisher ilealuretercreationforlongsegmentureteralinjuryasurgicalfilm AT samuellentz ilealuretercreationforlongsegmentureteralinjuryasurgicalfilm AT laurelberry ilealuretercreationforlongsegmentureteralinjuryasurgicalfilm |