Revision sheet

Ureterolysis with omental wrapping

9 steps, each one the authored title and caption from the interactive animation, with the frame captured from that step. Read it before the case, or print it and work through the steps in order.

Teaching only, not for diagnosis or treatment decisions. The text on this sheet is the animation's own step copy, reproduced verbatim.

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UrOops3D · UroRef · © Nity G

  1. 01

    Stents, then the plaque

    Ureterolysis with omental wrapping. Step 1: Stents, then the plaque. Captured frame from the interactive animation.
    • A stent is placed in each ureter from below.
    • Midline laparotomy; the white line of Toldt is opened and the right colon reflected medially.
    • A white plaque covers the cava and the aorta, and the ureter runs into it.
  2. 02

    Find the ureter above

    Ureterolysis with omental wrapping. Step 2: Find the ureter above. Captured frame from the interactive animation.
    • The ureter is found above the plaque, where it is wide.
    • It is dissected with its adventitia left on it and a vessel loop is passed round it.
    • It is then traced down to the plaque with the stent inside it as the guide.
  3. 03

    Biopsy

    Ureterolysis with omental wrapping. Step 3: Biopsy. Captured frame from the interactive animation.
    • Before any release a biopsy of the fibrotic tissue beside the ureter is taken and sent for histology, and the operation goes on.
    • The wedge is taken clear of the cava and of the ureter.
  4. 04

    Release, from above downwards

    Ureterolysis with omental wrapping. Step 4: Release, from above downwards. Captured frame from the interactive animation.
    • The ureter is released from the plaque by sharp and blunt dissection, from above downwards, and lifts out of its bed with its adventitia on it.
    • The cava, then the right common iliac vessels, lie deep and medial.
  5. 05

    A living ureter

    Ureterolysis with omental wrapping. Step 5: A living ureter. Captured frame from the interactive animation.
    • Once it is free the ureter is laid lateral without tension.
    • It fills with urine and stays pink along the whole freed length.
  6. 06

    Intraperitonealise

    Ureterolysis with omental wrapping. Step 6: Intraperitonealise. Captured frame from the interactive animation.
    • The ureter is positioned laterally and the posterior peritoneum is closed behind it with a running stitch.
    • The ureter now lies in the peritoneal cavity, off the plaque.
  7. 07

    Raise the omental flap

    Ureterolysis with omental wrapping. Step 7: Raise the omental flap. Captured frame from the interactive animation.
    • The omentum is mobilised off the greater curvature of the stomach with the gastroepiploic arteries kept on it, and divided at the middle of the curvature into two flaps.
    • The right flap is brought down to the right ureter.
  8. 08

    Wrap and drain

    Ureterolysis with omental wrapping. Step 8: Wrap and drain. Captured frame from the interactive animation.
    • The ureter is wrapped round its whole circumference in the flap along the freed length, and the flap is secured with interrupted stitches.
    • A drain is left in the retroperitoneum.
  9. 09

    The other side, and after

    Ureterolysis with omental wrapping. Step 9: The other side, and after. Captured frame from the interactive animation.
    • The right ureter lies lateral, in the peritoneal cavity, inside its omental flap.
    • The left ureter is released, placed and wrapped in the same way at the same operation.
    • The disease still needs its medical treatment and follow-up imaging.

Derived from pelvis/UreterolysisScene.tsx at build time: every step title and caption above is the authored ProcedureDef text, reproduced verbatim, and this page shares its readable-points renderer with the animation itself. 9 of 9 steps have a captured frame.

Text fingerprint a822d0d64280c34a. A caption edit without a re-capture fails the production check, so the sheet and the animation cannot drift apart silently.