How do I do it: Abdominal wall closure device-assisted minimally invasive cutaneous ureterostomy using a "loop-lift" maneuver for urgent diversion in young infants.

We describe an abdominal wall closure device (AWCD)-assisted minimally invasive cutaneous ureterostomy (CU) for young infants who require urgent, low-pressure diversion due to markedly dilated ureters (e.g., duplex-system ureterocele with high-grade reflux or other severe reflux/obstructive scenarios). Under laparoscopic vision, the AWCD is used to deliver and retrieve a suture loop beneath the markedly dilated ureter, enabling controlled elevation of the ureter along an extraperitoneal trajectory to a small skin incision with minimal ureteral mobilization. This "loop-lift" maneuver simplifies ureteral exposure, reduces tissue handling, and provides a reproducible pathway for rapid diversion prior to definitive reconstruction.