LAUSR

In gynecological oncologic surgery, partial ureteral resection may be required to achieve a complete resection of the disease. According to the length of ureteral defect, ureteroneocystostomy with psoas hitch can be indicated for ureteral reimplantation, especially when the resection involves the pelvic portion of the ureter. The principle of the psoas hitch technique is to mobilize the bladder, to transpose it to the ipsilateral psoas muscle, and to suture the ureter into the bladder with a tensionfree anastomosis. However, when ureteral resection is too large to perform a ureteral reimplantation with psoas hitch technique, Boari bladder flap can be performed. The psoas hitch technique was performed on a 75yearold patient diagnosed with a pelvic recurrence of a uterine sarcoma previously treated by total hysterectomy, bilateral salpingooophorectomy and adjuvant radiotherapy. The management of this recurrence required neoadjuvant chemotherapy with doxorubicin and dacarbazine before the surgical procedure. The surgery comprised the enbloc removal of the recurrence with a rectosigmoid resection and the resection of the pelvic portion of the left ureter. The patient consented to publication of this case study and the accompanying images. The video shows our proposed standardized surgical procedure which takes an open approach to create psoas hitch ureteral reimplantation in a stepwise approach (Video 1). The surgery also included a mechanical colorectal anastomosis and an omental flap which are not included in this video. We divided the procedure into 10 steps: Step 1: Specimen removal