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Regarding choice of external site of Mitrofanoff procedure (appendicovesicostomy)

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quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth -

"The site of the stoma on the skin is selected entirely for the patient’s convenience. The umbilicus provides a good passage and the best cosmetic result, but it is not an option in exstrophy patients. With patients in wheelchairs, the spine tends to become twisted with time, causing progressive abdominal compression, and the abdomen becomes hidden from the patient’s field of vision. For these patients, a stoma site close to the xiphisternum is the best option."

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