ABSTRACT
In this chapter, the authors review the technical details of Transappendicular Continent Cystostomy procedure. The presence of the appendix should be checked and preparation of possible alternative procedures done if a patient has a previous appendectomy. Then the cystostomy opening is made, at least 15 mm away from each flap edge, 20F wide, and the distal tip of the appendix is passed through that opening. Then, the bladder flap with the appendix is attached to the anterior abdominal wall with three to five slowly absorbable sutures. The mesoappendix should be oriented between the bladder flap and the abdominal wall. Then, the bladder flap in which the appendix has been fixed should be fixed to the abdominal wall by three to five absorbable sutures. If the umbilicus is chosen as the stoma site, six to eight monofilament 5-0 sutures should be used to perform the appendix to umbilical skin anastomosis, over a 14F Foley catheter.
