Laparoscopic repair of bladder injury

Article Abstract:

The case report is presented of a patient who underwent laparoscopy (viewing the pelvic organs by means of a fiberoptics tube inserted through a small incision in the abdominal wall) for the removal of adhesions (fibrous tissue growths); during the procedure she sustained two tears in the bladder. The injuries occurred when the trocar (a pointed instrument) was inserted, and they were first noted two hours after the surgical procedure began. The bladder injury was stitched closed and the repair was carefully evaluated. The suturing and monitoring techniques are described. The patient did well postoperatively and was in good health one year later. When women's bladders are injured in the course of a laparoscopically guided gynecological procedure, they often must undergo a subsequent laparotomy (surgical opening of the abdomen) to allow the injury to be repaired. This often leads to litigation. Some techniques, such as encouraging patients to void just before laparoscopy, reduce the risk of bladder injury. Surgeons should be able to suture during laparoscopy, in the event that complications arise. When bladder injury occurs, careful patient monitoring afterwards is mandatory; however, expansion of an initial injury can be prevented in many cases with proper laparoscopic suturing technique. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Injuries, Bladder, Surgical errors

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Incisional hernias after major laparoscopic gynecologic procedures

Article Abstract:

Surgeons performing laparoscopies should sew up the underlying tissue as well as the skin if they use a trocar larger than 10 millimeters. The trocar is the sharp instrument used to puncture the skin and abdomen prior to inserting the laparoscope. Laparoscopy is the examination of the interior of the abdomen using an instrument comparable to an endoscope. Among 3,560 operative laparoscopies performed at a hospital, six (0.17%) resulted in a herniation of abdominal organs through the site of the incision. All of these incisions had been made above or below the umbilicus. The incidence of incisional hernia was significantly higher when the incision was made with a 12 millimeter trocar than when it was made with a 10 millimeter trocar. Most surgeons only close the skin incision after performing laparoscopy, and most incisional hernias occur at umbilical incisions.

Causes of, Hernia

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Incisional hernia on the 5-mm trocar port site and subsequent wall endometriosis on the same site: A case report

Article Abstract:

A 26-year-old nulliparous patient, with recurrent pelvic pain and dysmenorrhea, was given a gynecologic examination, which revealed a 10-cm cyst on the left ovary. The cyst was extracted from the 10-mm umbilical incision, the other 2 trocars were put through 5-mm incisions and subsequently the patient was treated with gonadotropin-releasing hormone analogues for 6 months.

United States, Dysmenorrhea, Ventral hernia, Casualties

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