Case of vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy

Meguro, Satoru; Kirihana, Yusuke; Kumekawa, Tomoyuki; Kobayashi, Masato; Kono, Hiroshi

doi:10.1002/iju5.12346

Cited by 2 publications

(1 citation statement)

References 15 publications

(25 reference statements)

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“…Though there is no consensus on the most optimal route of repair, minimally invasive approaches (vaginal, laparoscopic, or combination) have become the predominant method of management in recent literature, with laparotomy reserved for patients with hemodynamic instability or necrotic bowel [1,2,11,37,38,[41][42][43][44][45].…”

Section: Managementmentioning

confidence: 99%

Prevention and management of vaginal cuff dehiscence: an updated review

Pinho

Liu

Kim

et al. 2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewMinimally invasive hysterectomy has gained popularity because of its many benefits. However, laparoscopic and robotic assisted hysterectomy have been associated with increased risk of vaginal cuff dehiscence. This review is meant to address risk management and prevention of vaginal cuff dehiscence in patients undergoing minimally invasive hysterectomy. Recent findingsRecent findings in the literature focus on addressing modifiable risk factors in patients and on using good surgical technique to help minimize the risk of vaginal cuff dehiscence.

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Section: Managementmentioning

confidence: 99%

Prevention and management of vaginal cuff dehiscence: an updated review

Pinho

Liu

Kim

et al. 2022

Current Opinion in Obstetrics &Amp; Gynecology

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Investigation of risk factors for vaginal dehiscence and development of small bowel evisceration after robot-assisted radical cystectomy for female bladder cancer and an improved vaginal reconstruction technique to prevent its onset

Fukata,

Kawaguchi,

Yoshimura

et al. 2024

J Robotic Surg

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Introduction Transvaginal organ prolapse, such as small bowel evisceration, is a rare complication after radical cystectomy (RC) in female patients with invasive bladder cancer, However, it often requires emergency surgical repair. Here, we describe our experience with such a case and a review of similar previously reported cases, along with evaluation of the risk factors. We also propose a vaginal reconstruction technique to prevent this complication during robot-assisted laparoscopic radical cystectomy (RARC).Methods A total of 178 patients who underwent laparoscopic radical cystectomy (LRC) or RARC were enrolled, 34 of whom (19%) were female. One of the 34 female patients had transvaginal small bowel evisceration after RARC. We evaluated our case and six such previously reported cases, to determine vaginal reconstruction techniques during RARC to prevent this complication postoperatively.Results Median age of these cases was 73 (51-80) years, and all patients were postmenopausal. The median time to small bowel evisceration was 14 (6-120) weeks postoperatively. In addition, we changed the methods of the vaginal reconstruction technique during RARC from the conventional side-to-side closure technique to the improved caudal-to-cephalad closure technique. Since implementing this change, we have not experienced any cases of vaginal vault dehiscence or organ prolapse.ConclusionsTransvaginal small bowel evisceration after RC can easily become severe. Therefore, all possible preventive measures should be taken during RARC. We believe that our vaginal reconstruction techniques might reduce the risk of developing this complication.

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Case of vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy

Cited by 2 publications

References 15 publications

Prevention and management of vaginal cuff dehiscence: an updated review

Prevention and management of vaginal cuff dehiscence: an updated review

Investigation of risk factors for vaginal dehiscence and development of small bowel evisceration after robot-assisted radical cystectomy for female bladder cancer and an improved vaginal reconstruction technique to prevent its onset

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