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Laparoscopic management of intentional and unintentional cystotomy
C H Nezhat1, D S Seidman, F Nezhat
1Department of Gynecology and Obstetrics, Stanford University School of Medicine, California, USA.
Purpose:
We assessed the laparoscopic closure of intentional or unintentional bladder lacerations during operative laparoscopy.
Materials And Methods:
Retrospective review of operative reports revealed 19 women who required bladder repair. The defect was repaired laparoscopically in 1 layer using interrupted absorbable polyglycolic suture (17 patients) or polydioxanone suture (2) and followed by 7 to 14 days of transurethral drainage.
Results:
Complications were limited to 1 vesicovaginal fistula that required reoperation. After 6 to 48 months of followup all patients were well with a good outcome.
Conclusions:
In select cases the bladder can be repaired safely and effectively during operative laparoscopy by an experienced laparoscopic surgeon.