Bricker’s ileal conduit urinary diversion in 10 logical steps

This 83-year-old patient with a history of endometrial cancer (clear cell carcinoma), was found to have a local central recurrent disease with urethral involvement, 6 years after primary curative surgery followed by pelvic radiotherapy. Multidisciplinary counseling was provided and, considering patient’s good condition, it was practiced anterior pelvic exenteration (Magrina III) with Bricker’s ileal conduit urinary diversion. Step 1: dissection of the right ureter Step 2: dissection of the left ureter Step 3: retroperitoneal transfer of the left ureter to the right side Step 4: selection of the ileal loop Step 5: preparation of the ileal loop Step 6: stapled side-to-side ileoileal anastomosis Step 7: urostomy fixation Step 8: introduction of ureteral stents Step 9: bilateral stented ileoureteral anastomosis Step 10: blue dye testing Strategy & approach Devices used No adjuvant treatment was indicated. Bibliography