Upper lib graft (ULG) for Redo urethroplasties in children. a Step by Step video

Abstract PURPOSE Lower lip and cheek are commonly used sources of buccal mucosa grafts for urethroplasty. In recent years, aiming to improve the donor site morbidity, our preference changed to the use (ULG). The aim of this video is to illustrate the technical details of the ULG harvesting for children. MATERIAL AND METHODS The inner surface of the upper lib is exposed by two stay sutures. The frenulum is spared, the mucosa to be harvested is marked and local submucosal infiltration is done with a solution of bupivacaine plus epinephrine. The edges are incised ant the submucosa plane created with a scissor. The graft is detached, defatted, and applied with quilting stitches over the recipient site with the standard technique. Hemostasis is secured and the donor site is left open. RESULTS From 2015 to 2018, 25 ULG harvests were done in 24 patients. Only one (5%) presented local pain associated to the procedure in the first 24 hours. After minimum 2 months after surgery, none of the patients presented perioral nubmness, difficulty with mouth opening, contraction of the donor site or changes in salivation. CONCLUSIONS ULG harvest is easy and a suitable alternative source of oral mucosa for urethroplasty in children.