Expanding the Armamentarium: Perspectives on Buccal Mucosal Grafts and Appendiceal Flaps in Ureteral Reconstructive Surgery
Dario Bello, Monica Van Shufflin, Matthias D. Hofer

TL;DR
This paper discusses the use of buccal mucosal grafts and appendiceal flaps as effective alternatives in complex ureteral reconstruction surgeries.
Contribution
The paper advocates for broader adoption of BMG and appendiceal techniques in ureteral reconstructive surgery.
Findings
BMG and appendiceal flaps offer advantages over traditional methods in managing complex ureteral strictures.
Robotic-assisted surgery enhances the feasibility of these techniques.
These methods reduce the need for bowel harvest and improve clinical outcomes.
Abstract
Management of complex and recurrent ureteral stricture disease remains one of the more challenging aspects of reconstructive urology. While standard techniques such as ureteroureterostomy, psoas hitch, Boari flap, and ileal ureter creation serve as the foundation of ureteral reconstruction, each technique has limitations, particularly when faced with recurrence, long strictures, and previously irradiated fields. Two alternative techniques—buccal mucosal graft (BMG) ureteroplasty and appendiceal onlay/interposition—have been previously described and are now being utilized more frequently in recent years. Furthermore, the advancement of robotic-assisted laparoscopic surgery has allowed for even more reconstructive capabilities. BMG ureteroplasty and appendiceal onlay/interposition can serve as valuable augmentations to the aforementioned surgical techniques. BMG has now long been…
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Taxonomy
TopicsUreteral procedures and complications · Urological Disorders and Treatments · Bladder and Urothelial Cancer Treatments
