Reconstruction of urinary bladder by laparoscopic surgery

Objective: To demonstrate the technique used to suture the urinary bladder by laparoscopic surgery. Design: Description of the case. Description of the case: Patient with pelvic trauma due to compression. He presented abdominal pain, stronger in the lower quadrant, abdominal hematoma extended from the umbilical area to the scrotus and perineum. A Foley catheter was inserted in the urinary tract and hematuria was noted. X rays showed a major fracture of the pelvis. Initial treatment was conservative and consisted in immobilizing the fracture, restoring volume, monitoring hemoglobin, hematocrit, and blood pressure, and antibiotic therapy. Afterwards, a diagnostic laparoscopy was performed, which revealed: hemorrhage in the abdominal wall, a lesion located in the south pole of the bladder of approximately 4 cm, partially sealed with ileum. Once the vesical lesion was exposed, we proceeded to close the defect, using standard interrupted suture and external knotting. Care was taken not to expose the suture to the urinary cavity before reinserting it into the front borderline. Vicryl 3-0 suture was used. The patient tolerated well the procedure and was discharged from the hospital on the third day after surgery. Clinical follow-up after 1 year yielded satisfactory results. Conclusion: It is feasible to repair the urinary bladder by means of laparoscopy.