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PMC4777234_02
The recipient ureter easily identified by the presence of the stent.. Notes: Thin arrow points at recipient ureter; thick arrow points at dilated donor ureter.
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The recipient ureter could be easily identified by the presence of the stent (Figure 1) and the dilated donor ureter was dissected free from the recipient ureter distally as close to the bladder as possible while safeguarding the periureteral adventitia with its blood supply.
Lifting a segment of recipient ureter by two transabdominal holding sutures.
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Therefore, in Case 2, we placed two transabdominal holding sutures using a 4-zero polydioxanone straight needle, going through the recipient ureter without hitching its wall or compromising its adventitial blood supply (Figure 2).
Longitudinal ureterotomy on recipient ureter.
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A longitudinal ureterotomy was made by scissors on the anteromedial aspect of the recipient ureter that matched the size of the divided donor ureter (Figure 3).
End-to-side ureteral anastomosis half completed on posterior side.
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An end-to-side anastomosis was fashioned from proximal to distal end using 5-zero monofilament absorbable continuous running suture starting on the posterior side (Figure 4).