psoas hitch
Pronunciation: SO-as hitch
Surgical technique securing the bladder to the psoas muscle to gain length for tension-free ureteral reimplantation.
Full Definition
Psoas hitch is a urologic reconstructive technique used to achieve additional bladder mobility and length during ureteral reimplantation procedures. The technique involves suturing the lateral aspect of the bladder to the psoas minor tendon or psoas muscle fascia, effectively advancing the bladder cephalad and laterally. This maneuver is particularly valuable when performing ureteroneocystostomy in cases where the ureter has been shortened due to trauma, stricture, or tumor resection. The psoas hitch can provide 3-5 cm of additional length, enabling tension-free anastomosis and reducing the risk of ureteral obstruction or vesicoureteral reflux post-operatively.
Usage
Usage note: Often combined with Boari flap for maximum ureteral length gain.
In Context
- "A psoas hitch was performed to achieve tension-free ureteral reimplantation after tumor resection." — Operative report
- "The combination of psoas hitch and Boari flap provided adequate length for the anastomosis." — Surgical technique description