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JSLS. 2001 Apr-Jun;5(2):175-7.

Laparoscopic hernia repair and bladder injury.

Author information

1
Stanford University, and Palo Alto VA HCS, Point Reyes Station, California 94956, USA. kmd@svn.net

Abstract

BACKGROUND:

Bladder injury is a complication of laparoscopic surgery with a reported incidence in the general surgery literature of 0.5% and in the gynecology literature of 2%. We describe how to recognize and treat the injury and how to avoid the problem.

CASE REPORTS:

We report two cases of bladder injury repaired with a General Surgical Interventions (GSI) trocar and a balloon device used for laparoscopic extraperitoneal inguinal hernia repair. One patient had a prior appendectomy; the other had a prior midline incision from a suprapubic prostatectomy. We repaired the bladder injury, and the patients made a good recovery.

CONCLUSION:

When using the obturator and balloon device, it is important to stay anterior to the preperitoneal space and bladder. Prior lower abdominal surgery can be considered a relative contraindication to extraperitoneal laparoscopic hernia repair. Signs of gas in the Foley bag or hematuria should alert the surgeon to a bladder injury. A one- or two-layer repair of the bladder injury can be performed either laparoscopically or openly and is recommended for a visible injury. Mesh repair of the hernia can be completed provided no evidence exists of urinary tract infection. A Foley catheter is placed until healing occurs.

PMID:
11394432
PMCID:
PMC3015440
[Indexed for MEDLINE]
Free PMC Article

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