Cloacal Exstrophy Repair

Anesthesia (not shown): GA in OR with Peripheral and Central Lines

1. Anatomy

2. Exposure

1. Draping and Planning
2. Mobilize Omphalocele and Ligate Umbilical Vessels
3. Establish Plane between Cecal Plate and Rectus Sheath
4. Identification of Bladder and Testicles
5. Identification of Hindgut and Future Stoma

3. Therapeutic Interventions

1. Closure of Cecal Plate
2. Reduce Bowel
3. Dissection to Identify Corpora
4. Division of Urogenital Diaphragm
5. Placement of Ureteral Catheters
6. Creation of Neo-urethra and Reassessment
7. Ostomy creation (not shown in this video)
8. Mobilization of Corporal Bodies
9. Place and Suture Malecot Suprapubic Catheter
10. Closure of Bladder
11. Placement of Pubic Symphyseal Stitch

4. Closure of Abdominal Defect

5. Leg Casting of Pelvic Osteotomies