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 div ersion, but conventional ileal conduits are not always suitable for patient s whose ureters are for the greater part compromised by neoplasm or preoper ative irradiation, resulting in a shortening of the ureters. Bowel migratio n into the large cavity, which develops after pelvic organ removal, appears to cause tension on the ureteroileal anastomotic site. Dextrotransmesenter ic placement of an ileal conduit may provide easy access to the shortened u reters without exerting pressure on the anastomosis. We employed this proce dure in seven patients undergoing pelvic exenteration with relatively minim al morbidity.