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Controlled balloon dilatation for laparoscopic extraperitoneal bladder neck suspension in patients with previous
F M Froeling1, J A Deprest, W M Ankum
1Department of Urology, Rode Kruis Ziekenhuis, The Hague, The Netherlands.
Purpose:
The balloon dilator is used in a variety of minimally invasive preperitoneal and retroperitoneal operations. In this study, we compared the ability to create an extraperitoneal cavity using a balloon spacer in patients with and without previous abdominal surgery undergoing laparoscopic bladder neck suspension.
Patients And Methods:
This prospective study included 38 patients in total, 15 of whom had had previous abdominal wall surgery and 23 who had not. A balloon spacer technique was used to develop the extraperitoneal space.
Results:
In 80% of the patients with previous surgery, the introduction of the balloon spacer was recorded as simple; in 20%, it was considered difficult. In 78% of the patients without previous surgery, the introduction of the balloon spacer was recorded as simple, in 17% it was difficult, and in 4% it failed. In 80% of the patients with previous surgery, the extraperitoneal view was good or acceptable, in 20% it was poor, and in 13% it failed. In 92% of the patients without previous surgery, the extraperitoneal view was good or acceptable, in 4% it was poor, and in 4% dilatation failed. Morbidity was equally divided between the groups.
Conclusions:
Previous abdominal surgery is not a contraindication to laparoscopic extraperitoneal surgery using a balloon spacer. The approach carries low morbidity, similar to that in patients without previous abdominal surgery.