Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay -
"To improve the efficacy of the antireflux mechanism, we suggest the following parameters: (a) suture the anastomotic line not only to the mucosa but also to the detrusor muscle to avoid excessive traction on the bladder mucosa; (b) suture the bladder to the abdominal wall, if the surgeon observes excessive traction; and (c) if it is possible according to the mesentery axes, the choice of the apex of the appendix for the bladder anastomosis would be easier to incorporate on the tunnel than the base of the appendix."
"To improve the efficacy of the antireflux mechanism, we suggest the following parameters: (a) suture the anastomotic line not only to the mucosa but also to the detrusor muscle to avoid excessive traction on the bladder mucosa; (b) suture the bladder to the abdominal wall, if the surgeon observes excessive traction; and (c) if it is possible according to the mesentery axes, the choice of the apex of the appendix for the bladder anastomosis would be easier to incorporate on the tunnel than the base of the appendix."