Laparoscopic management of intentional and unintentional cystotomy.

Abstract

We assessed the laparoscopic closure of intentional or unintentional bladder lacerations during operative laparoscopy. 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. 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. In select cases the bladder can be repaired safely and effectively during operative laparoscopy by an experienced laparoscopic surgeon.