Fig. 1

Construction of a modified ileal orthotopic bladder substitution. a Excision of a 56-cm ileal segment at least 25 cm proximal to the ileocecal junction was placed as a U shape. A 40-cm intermediate part was opened along the anti-mesenteric border. b A 5-mm diameter enterotomy was made at the apex of the U shape, where it was opened towards the mesenteric border and ready for anastomosis with the urethra. The medial borders of the incision were closed in a longitudinal fashion with 3-0 PDS continuous sutures to form the posterior wall of the neobladder. c and d The intermediate 40-cm ileal segment was used to construct the spheroidal-shaped neobladder. The 8-cm long proximal and distal ends of the ileal segment were used as afferent limbs, which were ready to anastomose with the ureter. e The elongated ileal tube was formed and ready to anastomose to the ureters