الفهرس 
EmbryologyOnly 14 pages are availabe for public view
 |  | from | 182 |  |  |
| | | from | 182 | | |
Abstract
In case of bladder augmentation with large bowel, a flap valve mechanism can be created by tunneling the ureter beneath a tenia. Important principles learned from ureterosigmoidostomy include direct mucosa-to-mucosa anastomosis and a submucosal tunnel of adequate length.
If a gastric segment is used for bladder augmentation or replacement, ureters may be reimplanted into the stomach in a manner remarkably similar to that used in the native bladder. It is easy to create a submucosal tunnel with good muscle backing. (Mark et al, 2002)
Creating an effective antireflux mechanism into an ileal segment is more difficult. The split/nipple technique may prevent reflux at least at low reservoir pressure. The nipple should be at least twice as long as the width of the ureter. In recent years, the serous-lined extramural-tunnel technique has been introduced into reconstructive surgery for the urinary tract and its value is now well appreciated. (Kato et al, 2001