Bladder injuries in emergency/expedited laparoscopic surgery in the absence of previous surgery: a case series

Levy, B.F.; Guara, J De; Willson, PD; Soon, Yuen; Kent, Andrew; Rockall, Tim

doi:10.1308/003588412x13171221502149

Cited by 30 publications

(24 citation statements)

References 6 publications

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“…One case involved injury to an urachal cyst [13], one to a possible patent urachus [7] and four cases involved injury to an urachal diverticulum [1,4,5,14]. Our case is the fifth such reported case of injury to an urachal diverticulum due to laparoscopic port insertion.…”

Section: Urachal Abnormalitiesmentioning

confidence: 80%

“…Injury to the urinary bladder due to suprapubic port insertion is rare. Levy et al reported six cases of bladder injury due to suprapubic port placement in 1,671 patients (incidence 0.36%) [4], with one of the six patients having an urachal diverticulum.…”

Section: Complication Rate Of Laparoscopymentioning

confidence: 99%

“…The reported incidence of a patent urachus is 3 per 100,000 births [2,4]. Urachal abnormalities are very rarely diagnosed clinically but due to the increasing use of diagnostic modalities such as ultrasound and computer-assisted tomography, it is being recognized more frequently.…”

Section: Urachal Abnormalitiesmentioning

confidence: 99%

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Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

Kumar¹,

Mehanna²

2015

J Med Cases

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Minimally invasive surgery has gained widespread acceptance in elective and emergency situations due to reduced pain, length of hospital stay for patients and wider view of the operative field. However, it does bring its own set of specific risks and complications that must be kept in mind. Injury to the urinary bladder, in particular in the setting of an undiagnosed urachal abnormality can easily go unrecognized at the time of operation. Injury to an unsuspected urachal diverticulum due to laparoscopic port placement is an extremely rare complication due to the very low incidence of this abnormality. We report a case of a 10-year-old boy who sustained an injury to an urachal diverticulum during a routine laparoscopic appendicectomy and give recommendations to minimize the risk of injury to the urinary bladder or an associated urachal diverticulum.

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Section: Urachal Abnormalitiesmentioning

confidence: 80%

Section: Complication Rate Of Laparoscopymentioning

confidence: 99%

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Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

Kumar¹,

Mehanna²

2015

J Med Cases

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“…Although Levy and colleagues reported only 0.36% (6/1671) of iatrogenic bladder injuries due to laparoscopic secondary port insertions in patients without prior history of abdominal surgery, one of their young patients developed a horrendous complication -gangrene of the abdominal wall (necrotising fasciitis). 25 The authors took into account all the laparoscopic cases (diagnostic and therapeutic), but failed to mention the study period. All but one of these patients underwent temporary preoperative in/out catheterization before surgery.…”

Section: Discussionmentioning

confidence: 99%

On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?

Nason

Baig²,

Burke

et al. 2015

CUAJ

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55case series AbstractIntroduction: Laparoscopic appendicectomy (LA) is the most commonly performed surgical emergency procedure. The aim of this study was to highlight a series of iatrogenic bladder injuries during LA and suggest a simple method of prevention. Methods: A retrospective review was carried out of all LA performed in a university teaching hospital over a two year period 2012-2013. Iatrogenic visceral injuries were identified and operative notes examined. Results: During the study period 1124 appendicectomies were performed. Four iatrogenic bladder injuries occurred related to secondary trocar insertion. No patient was catheterised preoperatively. One of the injuries was identified intra-operatively, another in the early postoperative period where as two re-presented acutely unwell post-discharge from hospital. Three were repaired by laparotomy and one laparoscopically. Conclusion: Iatrogenic secondary trocar induced bladder injuries are a rare but preventable and potentially serious complication of LA. Urethral catheterisation during LA is a safe and simple method which can prevent this complication. IntroductionAppendicectomy is the most common emergency surgical procedure performed worldwide.1 Laparoscopy plays a valuable role in the management of patients with acute lower abdominal pain. A Cochrane review has recommended laparoscopy and laparoscopic appendicectomy (LA) in patients with suspected appendicitis unless laparoscopy itself is contraindicated or not feasible.2 Minimally-invasive approaches have revolutionized surgery.3 Laparoscopic surgery has well-documented benefits with associated shorter length of stay, quicker return of bowel function, decreased analgesic requirements, lower rates of wound complications, and improved cosmesis.4,5 Furthermore LA is seen as an excellent training opportunity and evidence shows an attainable learning curve.6 LA is a safe procedure for junior trainees to perform; 7-9 however resident involvement in LA has resulted in increased operative time and complications. 10,11The overall rate of major complications following a laparoscopic procedure is about 1.4 per 1000 procedures. 12However, the incidence of port site complications following laparoscopic surgery is around 21 per 100 000 cases.13 Port site complications can be grouped into access-related complications (vascular or visceral injuries) 14 and postoperative complications (wound infection or port site herniation). 15,16Currently, there is little data regarding iatrogenic secondary trocar induced injuries in LA. The aim of this study was to highlight a series of iatrogenic bladder injuries during LA and suggest a simple method of prevention. MethodsWe performed a retrospective analysis of LA over a 2-year period (2012)(2013) at a tertiary referral university teaching hospital. Data were obtained from the hospital in-patient enquiry (HIPE) system. The outcomes measured included the incidence of iatrogenic bladder injuries at the time of LA, mode and time of clinical presentation, type of port used, le...

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“…The mortality rate associated with laparoscopy induced bowel injury is high at 3.6% (9). Reports of other visceral injuries in laparoscopic surgery can be found in the literature and include bladder injuries (11) and splenic injuries (12).…”

Section: Introductionmentioning

confidence: 99%

Real-Time Measurement of the Tool-Tissue Interaction in Minimally Invasive Abdominal Surgery

et al. 2016

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Bladder injuries in emergency/expedited laparoscopic surgery in the absence of previous surgery: a case series

Cited by 30 publications

References 6 publications

Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

Injury to Urachal Diverticulum Due to Laparoscopy Port: A Case Report, Literature Review and Recommendations

On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?

Real-Time Measurement of the Tool-Tissue Interaction in Minimally Invasive Abdominal Surgery

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