[Continent pre-peritoneal uretero-ileostomy with a hydraulic valve. A personal technique]

A continent ileal reservoir has been realized. The reservoir is placed outside the peritoneum, in a pre-peritoneal position, in order to allow its fixation by adhesions to the abdominal wall. Furthermore, a Benchekroun's hydraulic valve, adopted as a continent mechanism, is placed distant from the reservoir, by means of a long anti-peristaltic ileal loop, which further prevents the effects of the reservoir enlargement. The reservoir is made up using 40 cm of detubulized ileum; on the afferent loop (10 cm long) the right ureter is implanted according to the Camey-Le Duc technique, on the efferent loop (25 cm long) the left ureter is implanted according to the same technique. The remaining 15 cm of the ileum are used to realize a Benchekroun's hydraulic valve which is exteriorized by means of a skin stoma, placed on the left abdominal wall. With this technique, 18 patients have been operated; the follow-up period is 3 years for the first cases.