Transvesical Laparoendoscopic Single Site Surgery to Remove Surgical Materials Penetrating the Bladder: Initial Clinical Experience in 9 Female Patients

Abstract

No AccessJournal of UrologyAdult Urology1 Sep 2013Transvesical Laparoendoscopic Single Site Surgery to Remove Surgical Materials Penetrating the Bladder: Initial Clinical Experience in 9 Female Patients Marek Roslan and Marcin M. Markuszewski Marek RoslanMarek Roslan and Marcin M. MarkuszewskiMarcin M. Markuszewski View All Author Informationhttps://doi.org/10.1016/j.juro.2013.03.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The optimal approach for removing surgical materials that have penetrated the bladder is still debatable. We reviewed our initial experience with transvesical (percutaneous intraluminal access) laparoendoscopic single site surgery to treat such complications. We determined the safety, efficacy and morbidity of the procedure. Materials and Methods: In this case series study 9 women 24 to 63 years old were operated on from November 2009 to July 2012 due to bladder tape/mesh or surgical suture extrusion using the transvesical (percutaneous intraluminal access) laparoendoscopic single site surgery approach. We used the TriPort™ or TriPort+ single site access system, and a combination of straight and articulating or only standard laparoscopic instruments. A running V-Loc™ suture was placed as needed. In all cases followup included urine tests, abdominal ultrasound and cystoscopy. Results: Mean operative time was 59 minutes (range 35 to 105). Median postoperative hospital stay was 2.4 days. No blood loss or complications were observed except 1 conversion to open surgery because of a perivesical abscess. No extra port was added. No adverse events related to the method were observed during the mean 19-month followup. In 1 patient mesh extrusion recurred after 12 months of followup. Conclusions: We consider this technique to be an efficient, 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. References 1 : Intravaginal slingplasty (IVS): an ambulatory surgical procedure for the treatment of female urinary incontinence. Scand J Urol Nephrol1995; 29: 75. Google Scholar 2 : Presentation and management of major complications of midurethral slings: are complications under-reported?. Neurourol Urodyn2007; 26: 46. Google Scholar 3 : Management of iatrogenic foreign bodies of the bladder and urethra following pelvic floor surgery. Neurourol Urodyn2008; 27: 491. Google Scholar 4 : An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Int Urogynecol J2011; 22: 3. Google Scholar 5 : Managing complications after midurethral sling for stress urinary incontinence. EAU-EBU Update Series2007; 5: 232. Google Scholar 6 : Correction of erosions after suburethral sling insertion for stress incontinence: results and related sexual function. Eur Urol2009; 56: 371. Google Scholar 7 : Surgical intervention for complications of tension-free vaginal tape procedure. J Urol2003; 169: 570. Link, Google Scholar 8 : A safe and simple solution for intravesical tension-free vaginal tape erosion: removal by standard transurethral resection. BJU Int2008; 102: 582. Google Scholar 9 : Removal of an eroded transobturator tape from the bladder using laser cystolithotripsy and cystoscopic resection. Urology2009; 73: 681.e15. Google Scholar 10 : Laparoscopic removal of pubovaginal polypropylene tension-free tape slings. JSLS2006; 10: 220. Google Scholar 11 : Laparoscopic surgical complete sling resection for tension-free vaginal tape-related complications refractory to first-line conservative management: a single centre experience. Eur Urol2010; 58: 270. Google Scholar 12 : Antegrade endoscopic removal of retained urethral sling mesh in the bladder. J Endourol2012; 26: 980. Google Scholar 13 : Scarless endoscopic surgery: NOTES or TUES. Surg Endosc2007; 21: 1898. Google Scholar 14 : Single-port laparoscopic surgery in urology: initial experience. Urology2008; 71: 3. Google Scholar 15 : Single incision laparoscopic surgery in children—a preliminary report. Cent Eur J Urol2010; 63: 132. Google Scholar 16 : Laparoendoscopic single-site donor nephrectomy: a single-center experience. Urology2009; 74: 1238. Google Scholar 17 : Where do we really stand with LESS and NOTES?. Eur Urol2011; 59: 231. Google Scholar 18 : Single-port transvesical enucleation of the prostate: a clinical report of 34 cases. BJU Int2010; 105: 1296. Google Scholar 19 : A novel technique for distal ureterectomy and bladder cuff excision. Actas Urol Esp2011; 35: 168. Google Scholar 20 : Laparoendoscopic single-port transvesical diverticulectomy: preliminary clinical experience. J Endourol2012; 26: 975. Google Scholar 21 : Single-port transvesical excision of foreign body in the bladder. Urology2009; 74: 1347. Google Scholar 22 : Laparoendoscopic single-site transvesical removal of midurethral polypropylene sling eroded into the bladder. Videosurg Miniinv2011; 6: 111. Google Scholar 23 : Endoscopic holmium laser excision of intravesical tension-free vaginal tape and polypropylene suture after anti-incontinence procedures. J Urol2005; 174: 1175. Google Scholar 24 : Outcomes of transurethral removal of intravesical or intraurethral mesh following midurethral sling surgery. Korean J Urol2011; 52: 829. Google Scholar 25 : Urinary tract erosions after synthetic pubovaginal slings: diagnosis and management strategy. Urology2000; 56: 589. Google Scholar 26 : Transurethral and suprapubic mesh resection after Prolift® bladder perforation: a case report. Int Urogynecol J2010; 21: 1301. Google Scholar 27 : Purely transvaginal/perineal management of complications from commercial prolapse kits using a new prostheses/grafts complication classification system. J Urol2012; 187: 1674. Link, Google Scholar 28 : Mesh removal following transvaginal mesh placement: a case series of 104 operations. Int Urogynecol J Pelvic Floor Dysfunct2010; 21: 423. Google Scholar 29 : Consensus statement on the consortium for laparoendoscopic single site (LESS) surgery. Surg Endosc2010; 24: 762. Google Scholar Department of Urology, Medical University of Gdańsk, Gdańsk, Poland© 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 190 Issue 3 September 2013 Page: 909-915 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsurinary bladderslingscomplicationsdevice removaliatrogenic diseaseAcknowledgmentsDr. Nejat Düzgünes assisted with editing.Metrics Author Information Marek Roslan More articles by this author Marcin M. Markuszewski More articles by this author Expand All Advertisement PDF downloadLoading ...