Management of bladder cuff

After re-docking (Fig. 2, video presentation) we released the ureter, still connected to the kidney, with blunt and sharp dissection and followed it downwards to its bladder orifice. During this step the patient-side surgeon medialized peritoneum with the grasping forceps. To identify exact boarders of the ureteral orifice the bladder is filled by saline through the catheter. The detrusor muscle is then dissected until bladder mucosa can be visualized and circumferential en-bloc excision was initiated. Before entire dissection of the bladder cuff is executed one suture V-Loc 3-0 (Covidien^R, Dublin, Ireland) is attached at the medial dissection margin to prevent retraction of the bladder wall (Fig. 3, video presentation). We then resected the bladder cuff completely and bladder defect was closed in a running fashion using the attached suture. Patency check was warranted by irrigating the bladder catheter with saline.