LAPAROSCOPIC STAPLED BLADDER CLOSURE - LABORATORY AND CLINICAL-EXPERIENCE

We report our experience with closure of the bladder during laparoscop ic nephroureterectomy by using a gastrointestinal anastomosis type sta pling device designed to deliver 6, 3 cm. rows of 3.5 mm. titanium sta ples via a 12 mm. trocar. We initially used this stapling device to se cure a cuff of bladder in 8 female pigs undergoing laparoscopic nephro ureterectomy. Followup in these animals was completed 2 to 6 months po stoperatively. Then, 3 patients underwent laparoscopic ureterectomy us ing the laparoscopic stapler to transect and secure the ureter along w ith a cuff of bladder. In neither the laboratory nor the clinical situ ation were any complications encountered due to the transvesical stapl es (for example extravasation, stone formation, urinary tract infectio n or abscess formation). Our preliminary results indicate that titaniu m staples may be an effective method to provide rapid and secure closu re of the bladder in patients undergoing either laparoscopic nephroure terectomy or laparoscopic ureterectomy.