Intraoperative Catheter Management During Laparoscopic Excision of a Giant Bladder Diverticulum
| Autor: | Sepehr Khonsari, Jay Basillote, Ralph V. Clayman, Elspeth M. McDougall, David I. Lee |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Cystectomy Urinary catheterization Intraoperative Period medicine Humans Bladder diverticulum business.industry Urinary bladder neck obstruction Urinary Bladder Diseases Balloon catheter Middle Aged medicine.disease Surgery Urinary Bladder Neck Obstruction Diverticulum Neck of urinary bladder Catheter Treatment Outcome Laparoscopy Urinary Catheterization business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 14:47-50 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/109264204322862360 |
| Popis: | Massive bladder diverticula present a technical challenge to the laparoscopic surgeon. We describe a laparoscopic approach to transperitoneal diverticulectomy, using a specific catheter arrangement to allow excellent control of the various portions of the procedure.A 49-year-old male with longstanding frequency was diagnosed with a 1000 cc bladder diverticulum and bladder neck outlet obstruction. Laparoscopic transperitoneal diverticulectomy was performed using a triple catheter arrangement: endoscopic placement of a Councill catheter in the diverticulum, fluoroscopic positioning of an occlusion balloon catheter in the renal pelvis, and placement of a Cope loop suprapubic tube. Additionally, a transurethral incision of the prostate was performed.The procedure was completed laparoscopically using a four port transperitoneal approach. During the procedure, the diverticulum could be filled and emptied as needed; the catheter across the diverticular neck facilitated subsequent closure of the bladder wall defect. The diverticulum was completely excised. The remaining defect in the bladder was then closed in 2 layers. The patient was discharged on postoperative day 3.Careful planning and arrangement of catheters in the bladder, ureter, and diverticulum facilitates laparoscopic transperitoneal diverticulectomy of even a very large volume diverticulum. |
| Databáze: | OpenAIRE |
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