Laparoscopic management of intentional and unintentional cystotomy

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.