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The gasless laparoscopic Burch bladder neck suspension: early experience
1Department of Urology, Peel Memorial Hospital, Brampton, Ontario, Canada.
The Journal of Urology
|September 1, 1996
Summary
This study shows gasless laparoscopic Burch bladder neck suspension is a safe and effective treatment for stress urinary incontinence, with a high success rate and minimal complications. The procedure offers a faster recovery than traditional methods.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Gynecologic Surgery
Background:
- Stress urinary incontinence (SUI) significantly impacts quality of life.
- Traditional Burch bladder neck suspension can be invasive.
- Laparoscopic approaches aim to reduce surgical morbidity.
Purpose of the Study:
- To evaluate the efficacy and safety of gasless extraperitoneal laparoscopic Burch bladder neck suspension for type II SUI.
- To assess the feasibility of this technique in patients with prior pelvic surgery or obesity.
Main Methods:
- Retrospective analysis of 47 patients with type II SUI.
- Utilized balloon dissection for extraperitoneal space creation.
- Employed mechanical retraction and conventional laparoscopy instruments.
Main Results:
- 90% success rate (44/47 patients) with no pads required at follow-up (mean 8.2 months).
- Only 6% (3/47) conversion rate to open surgery, primarily due to blood loss.
- Average operative time: 96.4 minutes; average hospital stay: 3.5 days.
- Obesity and prior pelvic surgery were not contraindications.
Conclusions:
- Gasless laparoscopic Burch suspension demonstrates a lower open conversion rate compared to CO2 laparoscopy.
- The technique is potentially faster than conventional laparoscopic Burch procedures.
- It is a viable option for SUI, even in patients with complicating factors like obesity.