841 How to improve bricker ileal conduit functionality

Introduction/Background Bricker ileal conduit is a non-continent urinary reconstruction. In gynecologic oncology, it is usually performed after an anterior or total pelvic exenteration. Methodology The surgery was performed in a 53-year-old woman without comorbidities, who presented with a centro-pelvic relapse from a cervical adenocarcinoma 2 years after chemo-radiotherapy. Results Tips to ensure vascular supply: Selection of the bowel segment with non-disrupted vascular arcade within the mesentery (transillumination) Bowel mesenteric division preserving the vascular supply Removal of bowel ischemic areas if necessary ICG testing Tips to improve Bricker's functionality Ensure tension free to the stoma placement Select 15 cm of an ileal segment at approximately 15 from the ileocaecal junction Bricker's length according to patient's anatomy (wall thickness) Mark distal end to be fixed to the skin (bowel peristalsis) Ureteroenteric anastomosis : Wallace technic and interrupted suture Blue-dye test to identify anastomotic leaks Choose and mark stoma placement preoperatively by stoma nurse Eversion of the stoma to prevent skin complications Conclusion This video describes some tips and tricks to avoid ischemic complications and to improve Bricker's functionality. Disclosures Nothing to disclose.