Cloacal Exstrophy Repair

0. Preparation

• Anesthesia (not shown): GA in OR with peripheral and central lines.

1. Introduction

2. Anatomy

3. 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

4. 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. Mobilization of Corporal Bodies
8. Place and Suture Malecot Suprapubic Catheter
9. Placement of Suprapubic Tube
10. Closure of Bladder
11. Placement of Pubic Symphyseal Stitch

5. Component Closure of Abdominal Defect

6. Leg Casting for Pelvic Osteotomies