Ileal Replacement

The ileum is the final ending portion of the small intestine. It is surgical reconstruction of the ureter using a portion of ileum. The patient is given general anesthesia and turned on to the side. With respect to the diseased ureter, 4-5 keyhole incisions are made on the side of the body. Long and slender surgical instruments are inserted through these incisions. Through a cytoscope the surgeon has a clear view of the abdominal cavity. The ureter is exposed after the colon the covering of the kidney is taken off. The strictured area is dissected and made free from all attachments. The narrowed or portion with stricture is cut and removed. In case of shorter strictures the cut ends of the ureter are placed back together and sutured. A catheter may be placed in the bladder to drain the urine as the wounds heal.

In case of longer ones, the entire diseased part is removed. A part of the small intestine is brought out through one of the incisions and a part of the ileum with length equal to that of the cut portion of the stricture is detached from it. The rest of the small intestine is placed back to its normal position in the abdomen. With the help of sutures, newly obtained isolated portion of the ileum is connected from the kidney at one end to the healthy ureter at the other end. A stent is inserted into the bladder in order to protect the ileal ureter and is removed once wounds are healed.

Compared to the conventional open approach here the patient will feel less post operative pain and recovery time since the small incisions heal more quickly. The patients may be given regular diet by the first day after surgery. The After a stay in the hospital for 2-3 days, the patients can resume normal activities within a month.