2008 Annual Meeting Abstracts

---

Laparoscopic Repair Of Iatrogenic Bladder Injury
Sean A Castellucci, Phillip C Ginsberg, Richard C Harkaway, Michael J Metro, Lawrence H Belkoff, Justin D. Harmon, Jamison S Jaffe
Hahnemann University Hospital, Philadelphia, PA

Introduction: To evaluate the technique and results of laparoscopic cystorrhaphy after a laparoscopic iatrogenic bladder injury at a single institution.
Methods: From our patient database, we identified six patients that had iatrogenic bladder injuries during laparoscopic gynecologic procedures from January 2007 through April 2007. All of these patients underwent a laparoscopic cystorrhaphy by one surgeon. The procedure was performed using a two layer closure with 2-O vicryl, for a water-tight closure. A 20 French foley catheter was placed and the bladder was filled after the repair using 300ml of saline to test the integrity of the
repair. All demographic data, surgical details, anatomic location of bladder injuries, and outcome results were reviewed.
Results: Patient ages ranged from 35 to 50 for a mean patient age of 44±6 years. None of the patients had a visualized leak after repair intraoperatively, and all repairs were done through the already existing ports. A cystogram at one week follow up did not reveal any contrast extravasation. The foley catheter was removed on the same day of the cystogram in all patients. Mean follow up ranged from 7 to 10 months for a mean of 8.5 months. None of the patients have developed complications from the repair such as a fistula, urinary incontinence, bleeding, wound infection, bladder calculi or urinary tract infections. All patients have remained catheter free.
Conclusions: Patients undergoing laparoscopic surgery with an iatrogenic bladder injury identified at the time of surgery can be safely and effectively managed with a laparoscopic cystorrhaphy.

---