Endoscopic closure of transmural bladder wall perforations
Estevao Lima1, Carla Rolanda, Luís Osório
1Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.
European Urology
|June 24, 2008
Summary
This study shows that an endoscopic suturing kit can safely and effectively close bladder perforations in pigs. This technique offers a promising new approach for managing bladder injuries and advancing endoscopic surgery.
Area of Science:
- Minimally Invasive Surgery
- Urological Surgery
- Endoscopic Techniques
Background:
- Traditional treatments for bladder perforations include open or laparoscopic surgery.
- Transvesical access is feasible for natural orifice translumenal endoscopic surgery (NOTES), but requires reliable vesical closure.
Purpose of the Study:
- To evaluate the feasibility and safety of a novel endoscopic closure method for bladder perforations.
- Utilized a flexible, small-diameter endoscopic suturing kit in a survival porcine model.
Main Methods:
- Performed closure of full-thickness bladder incisions (up to 20 mm) using absorbable stitches.
- Assessed acute sealing with methylene-blue dye and monitored animals for 2 weeks post-procedure.
- Conducted necropsy to evaluate peritonitis, wound healing, and adhesions.
Main Results:
- Endoscopic closure was rapid and successful in all subjects.
- No acute leaks were observed during laparoscopic dye testing.
- Animals voided normally post-recovery, with complete healing and no signs of infection or adhesions at necropsy.
Conclusions:
- Demonstrated feasibility and safety of endoscopic bladder perforation closure in a porcine model.
- Supports further research into endoscopic bladder closure for managing bladder rupture.
- Suggests potential for transvesical port adoption in NOTES procedures.