Ureteric replacement with Meckel’s diverticulum

Authors from Germany describe the rather inventive use of Meckel’s diverticulum as a substitute for the ureter when a ureteric replacement is required. I thought that this paper would be of general interest to our readers, who may need to use this technique when presented with such a problem in their practice. OBJECTIVE To report on four patients with obstruction of the upper urinary tract due to severe ureteric strictures at different levels, in whom a Meckel’s diverticulum was used for ureteric replacement. PATIENTS AND METHODS The patients were aged 3–64 years at the time of operation. In every patient, a Meckel’s diverticulum was used to bridge a ureteric defect after recurrent reconstructive procedures. RESULTS The mean (range) follow‐up was 36 (12–69) months. There were no surgical complications, apart from mucus production in one case and renal function was normal in all patients after surgery. In one case, the invaginated Meckel’s diverticulum was used for reflux protection. CONCLUSIONS A Meckel’s diverticulum, if present, appears to be an ideal intestinal substitute for a ureteric defect. The advantages of its use are its unique blood supply, its mobility, and its minimization of functional bowel length resection.