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Bladder perforation during laparoscopic donor nephrectomy.

P D Metcalfe1, L Hickey, J G Lawen

  • 1Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.

The Canadian Journal of Urology
|January 8, 2005
PubMed
Summary
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Bladder perforation is a rare complication during laparoscopic donor nephrectomy. Careful peritoneal incision and dissection are crucial to prevent injury, especially in patients with prior abdominal surgeries.

Area of Science:

  • Urology
  • Surgical Complications
  • Nephrology

Background:

  • Laparoscopic donor nephrectomy is a common procedure for kidney transplantation.
  • Minimally invasive techniques aim to reduce patient morbidity.
  • Previous abdominal surgeries, such as tubal ligation, can lead to adhesions.

Observation:

  • Two cases of bladder perforation occurred during laparoscopic donor nephrectomy.
  • The diagnoses were made post-operatively.
  • Kidney extraction involved a Pfannenstiel incision and blunt peritoneal dissection.

Findings:

  • Bladder injury is a previously unreported complication of this procedure.
  • Adhesions from prior tubal ligations may increase the risk of bladder injury.
  • The bladder is susceptible to injury during peritoneal incision and dissection.

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Implications:

  • Increased vigilance is required during the peritoneal incision and dissection phases.
  • Surgeons should consider patient history of abdominal surgeries and potential adhesions.
  • This complication highlights the need for careful surgical technique in laparoscopic donor nephrectomy.