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Endoscopic closure of transmural bladder wall perforations

2009Journal article Open access
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dc.contributor.authorLima, E
dc.contributor.authorRolanda, C
dc.contributor.authorOsório, L
dc.contributor.authorPêgo, JM
dc.contributor.authorSilva, D
dc.contributor.authorHenriques-Coelho, T
dc.contributor.authorCarvalho, JL
dc.contributor.authorBergström, M
dc.contributor.authorPark, PO
dc.contributor.authorMosse, CA
dc.contributor.authorSwain, P
dc.contributor.authorCorreia-Pinto, J
dc.date.accessioned2012-06-29T12:45:37Z
dc.date.available2012-06-29T12:45:37Z
dc.date.issued2009
dc.description.abstractBACKGROUND: Traditionally, intraperitoneal bladder perforations caused by trauma or iatrogenic interventions have been treated by open or laparoscopic surgery. Additionally, transvesical access to the peritoneal cavity has been reported to be feasible and useful for natural orifice translumenal endoscopic surgery (NOTES) but would be enhanced by a reliable method of closing the vesicotomy. OBJECTIVE: To assess the feasibility and safety of an endoscopic closure method for vesical perforations using a flexible, small-diameter endoscopic suturing kit in a survival porcine model. DESIGN, SETTING, AND PARTICIPANTS: This pilot study was performed at the University of Minho, Braga, Portugal, using six anesthetized female pigs. INTERVENTIONS: Closure of a full-thickness longitudinal incision in the bladder dome (up to 10 mm in four animals and up to 20 mm in two animals) with the endoscopic suturing kit using one to three absorbable stitches. MEASUREMENTS: The acute quality of sealing was immediately tested by distending the bladder with methylene-blue dye under laparoscopic control (in two animals). Without a bladder catheter, the animals were monitored daily for 2 wk, and a necropsy examination was performed to check for the signs of peritonitis, wound dehiscence, and quality of healing. RESULTS AND LIMITATIONS: Endoscopic closure of bladder perforation was carried out easily and quickly in all animals. The laparoscopic view revealed no acute leak of methylene-blue dye after distension of the bladder. After recovery from anaesthesia, the pigs began to void normally, and no adverse event occurred. Postmortem examination revealed complete healing of vesical incision with no signs of infection or adhesions in the peritoneal cavity. No limitations have yet been studied clinically. CONCLUSIONS: This study demonstrates the feasibility and the safety of endoscopic closure of vesical perforations with an endoscopic suturing kit in a survival porcine model. This study provides support for further studies using endoscopic closure of the bladder which may lead to a new era in management of bladder rupture and adoption of the transvesical port in NOTES procedures.por
dc.identifier.citationEur Urol. 2009;56(1):151-7.por
dc.identifier.urihttp://hdl.handle.net/10400.26/2322
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherElsevierpor
dc.relationTacographic, spectral and fractal heart rate analysis during pre and post-natal life. Applications in medical diagnostic and educational systems.
dc.subjectCitoscopiapor
dc.subjectTécnicas de Suturapor
dc.subjectBexiga Urináriapor
dc.subjectAnimaispor
dc.subjectCirurgia Endoscópica Transluminal por Orifícios Naturaispor
dc.titleEndoscopic closure of transmural bladder wall perforationspor
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleTacographic, spectral and fractal heart rate analysis during pre and post-natal life. Applications in medical diagnostic and educational systems.
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/POSC/POSI%2FCPS%2F40153%2F2001/PT
oaire.fundingStreamPOSC
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspor
rcaap.typearticlepor
relation.isProjectOfPublicationaaf9e509-d017-4986-8fba-2f52a512aee4
relation.isProjectOfPublication.latestForDiscoveryaaf9e509-d017-4986-8fba-2f52a512aee4

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