Transvesical laparoendoscopic single-site surgery for removal of surgical materials penetrating into the bladder: Initial clinical experience with nine female patients

Abstract

Purpose

The optimal approach for the removal of surgical materials that have penetrated into the bladder is still debatable. We reviewed our initial experience with transvesical (percutaneous intraluminal access) laparoendoscopic single-site surgery ( T-LESS) to treat such complications. We determined the safety, efficacy and morbidity of the procedure.

Materials and Methods

In this case series study, from November 2009 to July 2012, nine women aged 24 to 63 were operated on for bladder tape/mesh or surgical suture extrusions, using the T-LESS approach. In the procedures, the TriPort® or TriPort+® single-site access systems, and either a combination of straight and articulating, or only standard laparoscopic instruments were used. The running V-loc® suture was placed when necessary. In all cases, the follow-up included urine tests, abdominal ultrasonography, and cystoscopy.

Results

The mean operative time was 59 min (range, 35–105 min), and the median hospital stay after the procedure was 2.4 days. No blood loss or complications were observed, except for one conversion to an open surgery because of a perivesical abscess. No extra port was added. No adverse events related to the method were observed during the mean follow-up time of 19 months. In one patient a recurrence of the mesh extrusion was observed after 12 months of follow-up.

Conclusions

We consider this technique to be an efficient and safe procedure, and a valuable minimally invasive treatment option for foreign body removal from the bladder; however, further observations are needed to prove the validity of the method.

http://www.jurology.com/article/S0022-5347(13)03669-0/abstract