Surgical technique

A 45 cm ileal segment was separated, starting at an appropriate point 15 to 20 cm from the ileocecal junction to avoid gastrointestinal problems postoperatively (Fig. 1). The intestinal continuity was rebuilt by an end-to-end anastomosis with surgical staplers (Fig. 2). The whole separated ileal segment was cut at the antimesenteric border for detubularization. Proximal and distal sides of the ileal loop were anastomosed side-to-side and a bagel-shaped detubularized ileal segment was formed (Figs. 3 and ​and4).4). Three identical points, starting from the medial border of the anastomosis segment, were identified and united at the center. Then, the medial edges of the ileal loop were joined by a running through-and-through suture of 3–0 polyglactin continuously, resulting in a goosefoot image in the centrum (Fig. 5). After this stage, a triangular configuration was formed. Also, three points from the lateral side of the detubularized ileal loop were identified and united at the center, and the lateral edges of the ileal loop were sutured continuously with 3–0 polyglactin, leaving the lower part of the reservoir open for the urethroileal anastomosis. Both ureters were spatulated and anastomosed end-to-side to the neobladder over appropriate single J stents with an antireflux mechanism (Fig. 6). The ureteral stents were fixed to the ileal mucosa and taken out of the pouch by stabbing the anterior wall of the reservoir (Fig. 7). The urethroileal anastomosis was performed over a transurethral 22-French catheter with six to eight 3–0 polyglactin sutures. The pelvis was drained with a 28-French tube drain.

A 45 cm ileal segment was selected, starting at an appropriate point 15 to 20 cm from the ileocecal junction

The intestinal continuity is rebuilt by an end-to-end anastomosis with surgical staplers

The whole separated ileal segment is cut at the antimesenteric border for detubularization

A bagel-shaped detubularized ileal segment is formed

Three identical points, starting from the medial border of the anastomosis segment, are identified and united at the center, and the medial edges of the ileal loop are joined

Both ureters are spatulated and anastomosed end-to-side to the neobladder over appropriate single J stents with an antireflux mechanism

The triangular-shaped Anatolian pouch is formed. The ureteral stents are fixed to the ileal mucosa and taken out of the pouch by stabbing the anterior wall of the reservoir. The urethroileal anastomosis is performed over a transurethral 22-French catheter with six to eight 3–0 polyglactin sutures