Sustitución parcial del uréter por un segmento de íleon tratado según el procedimiento de Monti

Abstract

Partial Substitution Of The Ureter Using A Short Segment Of The Ileum Following The Monti ProcedureThe partial substitution of the ureter using a pediculated segment of the ileum is a technique used to re-establish ureteral transit and preserve the renal unit, following the resection of extensive ureteral lesions. Standard surgical procedure for an ileoureteroplasty consists of isolating an ileal duct of equal or greater length than the ureteral defect and interposing it in the urinary tract in an isoperistaltic direction.Monti described a surgical technique that allows for the creation of catheterizable stomas in continent urinary diversions, using the Mitrofanoff principle. These passageways were created from one or several 2.5 cm long ileal sections by means of their detubulization and transverse retubulization.The clinical case study presented here corresponds to a 57 year-old male with a history of ureteral lithiasis, with a 9 cm stenosis of the sacroiliac ureter. He was treated surgically by means of a resection of the stenotic ureter and the interposition of a duct made up of 2.5 ileal sections, treated in accordance with the Monti procedure. Since this operation, the patient’s metabolic state has been completely normal. Morphological and functional results have also proved totally satisfactory, as the use of image techniques have shown.