Stepladder incision technique for lengthening of bowel mesentery

A tension-free bowel anastomosis is essential when bowel segments are used in reconstructive urological procedures. A safe and effective technique is described to lengthen the mesenteric vascular pedicle. Serial incisions are made in the mesenteric peritoneum horizontally, perpendicular to the vascular plane on both sides of the mesentery. This technique has provided up to 3 cm. of additional length without complication in 3 cases.