On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Urology

Background:

• Laparoscopic appendicectomy (LA) is a common emergency surgical procedure.
• Iatrogenic bladder injuries are a potential complication during LA.
• This study addresses the incidence and prevention of these injuries.

Purpose of the Study:

• To identify iatrogenic bladder injuries during laparoscopic appendicectomy.
• To propose a simple preventative measure for bladder injuries.
• To analyze the outcomes of these injuries.

Main Methods:

• Retrospective review of laparoscopic appendicectomies performed between 2012-2013.
• Identification and examination of operative notes for iatrogenic visceral injuries.
• Analysis of injury timing, management, and patient outcomes.

Main Results:

• Four iatrogenic bladder injuries occurred during 1124 LA procedures.
• All injuries were related to secondary trocar insertion; no patients were preoperatively catheterized.
• Injuries were identified intraoperatively, postoperatively, or after discharge; three required laparotomy for repair.

Conclusions:

• Iatrogenic bladder injuries from secondary trocar insertion in LA are rare but serious.
• These injuries are preventable with a simple intervention.
• Urethral catheterization during LA is a safe and effective preventative method.