Bricker Technique of Uretero-Ileal Anastomosis for Duplex Ureters Undergoing Intracorporeal Ileal Conduit Construction

Abstract

Introduction

Bladder cancer in patients with ureteral anomalies presents unique surgical challenges, particularly regarding urinary diversion. This case highlights a novel approach to uretero-ileal anastomosis in a patient with duplicated right ureters undergoing radical cystectomy.

Case Presentation

A 65-year-old man with cT2N0M0 bladder cancer underwent transurethral resection of the bladder tumor, revealing a complete duplex right ureter. Following neoadjuvant chemotherapy, he underwent robot-assisted radical cystectomy with intracorporeal ileal conduit construction. The left ureter was anastomosed using the Bricker technique. To optimize right ureteral drainage, slits were made in both ureters, and their medial margins were sutured to form a Wallace plate, which was subsequently anastomosed to the ileal conduit. Ureteral stents were removed successfully after 2 weeks.

Conclusion

One year postoperatively, no urinary diversion-related complications occurred. The uretero-ileal anastomotic technique should be selected based on the case and the surgeon's or institution's experience.