LAPAROSCOPIC REPAIR OF BLADDER INJURY AND LACERATION

The management of bladder injuries at laparoscopy is controversial. So me endoscopists believe in mandatory open repair, whereas others recom mend laparoscopic cystotomy repair. We performed laparoscopy to treat two women with bladder injury, one with excision of a transmural nodul e of bladder endometriosis, and the other with incidental cystotomy du ring adenexectomy in the presence of obliterative adhesions. After loc alizing the injury to the dome of the bladder remote from ureters, the edges of the injury were cleaned of damaged tissue and apposed in two layers using interrupted 4-0 polydioxanone endocorporeal sutures. The patients had an uneventful postoperative course, and neither experien ced bladder function problems. We conclude that applying the already e stablished tenets of bladder injury repair by laparotomy to laparoscop ic procedures is acceptable in most endoscopic settings.