Transposition of Left Ureter

The ureters are dissected proximally for a length sufficient to reach the proximal end of the ileal segment. Care is taken to preserve periureteral tissue and thus the ureteral

The following two options are available: (i) Reopen the infraumbilical incision, deliver the Studer limb extracorporeal^, and perform the anastomosis in an open fashion. (ii) Particularly in obese patients, bilateral anastomoses are performed completely intracorporeally.

vascular supply. The sigmoid colon is retracted superiorly and anteriorly. Blunt dissection is used to develop a tunnel posterior to the sigmoid mesocolon and anterior to the sacrum. The left ureter is passed under the sigmoid colon using the previously placed holding suture. Ureteral length is once again confirmed to assure that both ureters reach the proximal portion of the ileal segment in order to avoid undue tension on the anastomoses.

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