An alternative procedure for the creation of an ileal conduit in patients undergoing pelvic exenteration: dextrotransmesenteric location

Ileal conduits have long been accepted as a standard method for urinary diversion, but conventional ileal conduits are not always suitable for patients whose ureters are for the greater part compromised by neoplasm or preoperative irradiation, resulting in a shortening of the ureters. Bowel migration into the large cavity, which develops after pelvic organ removal, appears to cause tension on the ureteroileal anastomotic site. Dextrotransmesenteric placement of an ileal conduit may provide easy access to the shortened ureters without exerting pressure on the anastomosis. We employed this procedure in seven patients undergoing pelvic exenteration with relatively minimal morbidity.