Modified Bricker Ureteroileal Anastomosis

Introduction: Radical cystectomy remains to be the standard of care for muscle invasive bladder cancer. In most of the cases, ureteroileal anastomosis is commonly performed using Bricker technique. Here we describe a modified Bricker technique that minimizes anastomotic complications and helps to preserve the ureter vascularity. Materials and Methods: In our study, 74 patients between January 2011 and January 2018 who underwent modification of Bricker technique at two different centers were analyzed retrospectively. The modified procedure involves an end-to-end anastomosis of the left ureter and an end-to-side anastomosis of the right ureter to the ileal segment. Left ureter was brought on right side of the retrosigmoid. Visible peristalsis, good color with healthy mucosa, and bleeding edges were considered as signs of good vascularity. The analyzed parameters were perioperative and postoperative outcomes. Results: In this study, the mean operative duration was 307.2 minutes and duration for this step was 15 minutes. No major perioperative complications were recorded. The Single-J was removed between 8 and 10 days after surgery. No patient had ureteroileal anastomotic complications such as leakage or stricture after a median follow-up of 18 months. Recurrence was detected in one patient. Conclusion: The described ureteroileal diversion is a safe efficacious procedure with low morbidity and may serve as an alternative for the standard Bricker technique. This technique negates our concern about the anastomotic complications and provides excellent functional results. No competing financial interests exist. Runtime of video: 4 mins 2 secs Consent Statement: The authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.