South Clin Ist Euras. 2021; 32(2): 176-180 | DOI: 10.14744/scie.2021.86094

Laparoscopic Management of Bladder Injury During Total Laparoscopic Hysterectomy

Emre Mat¹, Gazi Yýldýz¹, Gulfem Basol¹, Didar Kurt¹, Betul Kuru¹, Elif Cansu Gundogdu¹, Onder Sakin¹, Umit Cabus³, Pýnar Yýldýz², Ahmet Kale^1
1Department of Obstetrics and Gynecology, Health Sciences University Ýstanbul Kartal Dr. Lütfi Kýrdar City Hospital, Ýstanbul, Turkey
²Department of Obstetrics and Gynecology, Adatýp Kurtköy Hospital, Ýstanbul, Turkey
³Department of Obstetrics and Gynecology, Pamukkale University Faculty of Medicine, Denizli, Turkey

INTRODUCTION: The rate of bladder injury during laparoscopic hysterectomy (LH) is three-fold higher than that of ureter injury and is an important problem for gynecologists. The aim of the present study was to present the results of laparoscopic repair of bladder injuries produced during LH procedure.
METHODS: Patients who underwent LH for benign indications between November 2018 and January 2020 were evaluated retrospectively. Medical records of all patients with bladder injury were reviewed and their causes of injury, incidence, treatment and follow-up were evaluated.
RESULTS: Eight patients were established to have bladder injury while undergoing LH. All bladder injuries were recognized during operation. Bladder injury occurred during laparoscopic sharp and blunt dissection of uterovesical area in seven patients and during suprapubic trochar insertion in one patient. All bladder injuries were repaired laparoscopically. No major complications were encountered during or after operation. Bladder catheters were removed 7–10 days after surgery.
DISCUSSION AND CONCLUSION: It was demonstrated that laparoscopic repair of bladder injury, which is a feared complication of LH, can be carried out successfully be gynecologists experienced in endoscopic surgery.

Keywords: Hysterectomy, injury; laparoscopy; repair; urinary bladder.

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Total Laparoskopik Histerektomi Sýrasýnda Mesane Yaralanmasýnýn Laparoskopik Yönetimi

Emre Mat¹, Gazi Yýldýz¹, Gulfem Basol¹, Didar Kurt¹, Betul Kuru¹, Elif Cansu Gundogdu¹, Onder Sakin¹, Umit Cabus³, Pýnar Yýldýz², Ahmet Kale^1
1Ýstanbul Kartal Dr. Lütfi Kýrdar Þehir Hastanesi, Kadýn Hastalýklarý ve Doðum Kliniði, Ýstanbul, Turkey
²Kadýn hastalýklarý ve doðum kliniði, Adatýp Kurtköy Hastanesi, Ýstanbul,Türkiye
³Kadýn hastalýklarý ve doðum kliniði, Pamukkale Üni. Týp Fakültesi, Denizli,Türkiye

GÝRÝÞ ve AMAÇ: Laparoskopik histerektomi (LH) sýrasýnda mesane yaralanmasý, üreter yaralanmasýndan yaklaþýk olarak üç kat daha fazla görülmektedir ve jinekologlar için hala önemli bir problem oluþturmaktadýr. Çalýþmamýzýn amacý, laparoskopik histerektomi sýrasýnda oluþan mesane yaralanmalarýnýn laparoskopik olarak onarýlmasýnýn sonuçlarýný sunmaktýr.
YÖNTEM ve GEREÇLER: Kasým 2018 ile Ocak 2020 arasýnda benign jinekolojik nedenlerle LH yapýlan hastalar geriye dönük olarak incelendi. Mesane yaralanmasý izlenen tüm hastalarýn týbbi kayýtlarý incelendi, yaralanma nedenleri, insidansý, tedavi ve takipleri deðerlendirildi.
BULGULAR: Laparoskopik histerektomi sýrasýnda mesane yaralanmasý olan sekiz hasta saptandý. Mesane yaralanmalarýn hepsi operasyon sýrasýnda farkedildi. Yedi hastada utero–vezikal alanýn laparoskopik olarak keskin ve künt diseksiyonu sýrasýnda, bir hastada da suprapubik trokar giriþi sýrasýnda mesane hasarý oluþtuðu izlendi. Mesane hasarlarýnýn tümü laparaskopik olarak onarýldý. Cerrahi sýrasýnda ve sonrasýnda hiçbir hastada majör bir komplikasyon izlenmedi. Mesane katateri cerrahiden 7–10 gün sonra çýkarýldý.
TARTIÞMA ve SONUÇ: Laparoskopik histerektominin korkulan bir komplikasyonu olan mesane yaralanmalarýnýn laparoskopik onarýmý, endoskopik cerrahide deneyimli bir jinekologlar tarafýndan da baþarý ile yapýlabileceði gösterilmiþtir.

Anahtar Kelimeler: Histerektomi, laparaskopi; mesane; onarým; yaralanma.

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