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Laparoscopic repair in children with traumatic bladder perforation
Cetin Ali Karadag1, Burak Tander2, Basak Erginel1
1Department of Pediatric Surgery, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.
Insights
This study demonstrates that laparoscopic intracorporeal sutures are a safe and effective method for repairing traumatic bladder dome ruptures in children. This minimally invasive technique offers superior cosmetic outcomes compared to traditional methods.
Area of Science:
- Urology
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Traumatic intraperitoneal bladder dome rupture is a rare but serious injury.
- Traditional open surgical repair can lead to significant morbidity and poor cosmetic results.
Observation:
- Two pediatric cases of traumatic bladder dome rupture are presented.
- Both patients sustained injuries from significant blunt abdominal trauma, resulting in pelvic fractures and intraperitoneal bladder perforation.
- Diagnostic imaging included CT scans and cystography, confirming bladder dome rupture with extravasation.
Findings:
- Laparoscopic exploration revealed 3-cm perforations at the bladder dome in both patients.
- Both injuries were successfully repaired using laparoscopic intracorporeal sutures in a two-layer fashion.
- Post-operative recovery was uneventful for both children.
Implications:
- Laparoscopic repair of traumatic bladder dome rupture is a safe, effective, and minimally invasive surgical option.
- This technique offers improved cosmetic outcomes, particularly beneficial in pediatric patients.
- Intracorporeal suturing for bladder dome injuries represents a significant advancement in pediatric urological surgery.
Abstract:
Here, we report two patients with a traumatic intraperitoneal bladder dome rupture repaired by laparoscopic intracorporeal sutures. The first patient was a 3-year old boy was admitted with a history of road accident. He had a traumatic lesion on his lower abdomen and a pelvic fracture. Computed tomography (CT) scan revealed free intraabdominal fluid. The urethragram showed spreading contrast material into the abdominal cavity. Laparoscopic exploration revealed a 3-cm-length perforation at the top of the bladder. The injury was repaired in a two fold fashion. Post-operative follow-up was uneventful. The second case was a 3-year-old boy fell from the second floor of his house on the ground. He had traumatic lesion on his lower abdomen and a pelvic fracture. Due to bloody urine drainage, a cystography was performed and an extravasation from the dome of the bladder into the peritoneum was detected. On laparoscopy, a 3-cm long vertical perforation at the dome of the bladder was found. The perforation was repaired in two layers with intracorporeal suture technique. The post-operative course was uneventful. Laparoscopic repair of traumatic perforation of the bladder dome is a safe, effective and minimally invasive method. The cosmetic outcome is superior.
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