October 10, 2025Oct 10 quotes from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -"The repair of cloacas with longer common channels (>3 cm) represents a real technical challenge and requires a great deal of experience in the management of these cases. For that kind of patient, the pediatric surgeon and/or pediatric urologist should have experience in the management of the urinary structures, including bladder reconstructions, bladder neck reconstructions, ureteral reimplantations, bladder augmentation, and Mitrofanoff procedures, as well as vaginal replacements using rectum, colon, or small bowel.""If the common channel is longer than 5 cm, we recommend opening the abdomen directly in the midline, because the rectum and vagina are not accessible posterior sagittally and are more easily accessed through the abdomen. If the common channel is between 3 and 5 cm, the surgeon can open posterior sagittally, find the vagina or vaginas, and can try to repair them by performing the total urogenital mobilization. If the total urogenital mobilization proves not to be enough to repair the malformation, then the operation must be completed through a laparotomy."
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