Anatomic Module: Vesicourethral Anastomosis
On this page:
- Supplies and Setup
- Instructions and Objectives
Supplies and Setup
- Suture board material (we use the Sim*Vivo suture material)
- Marking pen
- 24Fr Foley catheter
- Standard dish sponge
- Thick non-absorbable suture (we use 2-0 nylon)
- Anastomosis suture (we use 2 4-0 monofilament absorbable sutures)
- Paper cup
- Cut a 1cm diameter hole in your suture material. This will be the transected bladder neck.
- Using your marking pen, mark your bilateral ureteral orifices (UOs) about 1cm diagonally away from your bladder neck in each direction.
- Fold your suture material in half and clip it into the clipboard with your bladder neck facing away from the clip and the UOs on the bottom side.
- Cut the end off of a 24Fr Foley catheter. This will be the transected urethra.
- Moisten your sponge and wrap it lengthwise around the catheter. Use your nonabsorbable suture to keep the sponge in place. This will be the periurethral tissue.
- Punch out the bottom of your paper cup. Cut off the top half of the rim of the cup as well. This will be the bony pelvis.
- Secure the pelvis and urethra to your clipboard using 2 rubber bands. This should be positioned such that the cut end of the urethra comes into contact with the bladder neck when the bladder neck is on a very mild amount of stretch.
- Prepare your anastomosis suture(s) as you like. We cut two sutures to 6-inch pieces and tie them together at their tails.
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