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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

TRONCOSO C, Pablo; SAAVEDRA Z, Álvaro; SARRAS J, Miguel  y  ROJAS R, Francisco. Intraperitoneal bladder rupture and laparoscopic repair: is this the new gold standard?. Rev Chil Cir [online]. 2012, vol.64, n.6, pp.567-571. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262012000600012.

Introduction: Nowadays laparoscopy is the new paradigm in many surgical treatments; however, its role in urological trauma is barely emerging. The aim of this article is to show a laparoscopic repair technique of an intraperitoneal bladder rupture secondary to a blunt abdominal trauma, its feasibility and safety. Case: We present a 28 year old man who consulted with 6 hours of hypogastric pain, absence of micturition and vesical globe, after alcoholic consumption. He presented high blood both creatini-ne and inflammatory parameters. A Foley catheter was installed, the pain increased progressively, with Blumberg sign and tachycardia. Looking back again, he told about a blow in the hypogastric region with full bladder. A non-contrasted CT of the pelvis showed the catheter's end into peritoneal cavity. A successfully three port laparoscopic repair was made using intracorporeal double layer suturing technique with poliglactin, an intraoperative cystoscopic check was performed. The patient was discharged at sixth day without complications.Discussion: Classically surgical treatment for intraperitoneal bladder rupture has been laparotomy with double layer closure of the lesion. However, there are no randomized control trials comparing this technique with other methods. Also, there is a lack of laparoscopic repair reports, probably due to most bladder ruptures are extraperitoneal (managed with non-surgical treatment) or associated with other organs injury (needing laparotomy). Although more evidence is needed, we believe that laparoscopic repair of intraperitoneal bladder rupture could be considered as an option in stable patients and without important associated injuries, achieving better cosmetic outcomes and faster recovering.

Palabras clave : Urinary bladder; wounds injuries; laparoscopy.

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