Endoscopic closure of transmural bladder wall perforations
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/67597 |
Resumo: | Background: 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. |
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Endoscopic closure of transmural bladder wall perforationsAnimalsCystoscopyCystotomyFeasibility StudiesFemaleIatrogenic DiseasePilot ProjectsRuptureRupture, SpontaneousSwineTreatment OutcomeUrinary BladderWounds, PenetratingSuture TechniquesNOTESEndoscopyMinimally invasive surgerySuturingBladderScience & TechnologyBackground: 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.ElsevierUniversidade do MinhoLima, Estêvão Augusto Rodrigues deRolanda, CarlaOsório, LuísPêgo, José M.Silva, DavidHenriques-Coelho, TiagoCarvalho, José LBergström, MariaPark, Per-OlaMosse, Charles A.Swain, PaulCorreia-Pinto, Jorge2009-072009-07-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/67597eng0302-283810.1016/j.eururo.2008.06.01018571311info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:31:53Zoai:repositorium.sdum.uminho.pt:1822/67597Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:27:11.151218Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Endoscopic closure of transmural bladder wall perforations |
title |
Endoscopic closure of transmural bladder wall perforations |
spellingShingle |
Endoscopic closure of transmural bladder wall perforations Lima, Estêvão Augusto Rodrigues de Animals Cystoscopy Cystotomy Feasibility Studies Female Iatrogenic Disease Pilot Projects Rupture Rupture, Spontaneous Swine Treatment Outcome Urinary Bladder Wounds, Penetrating Suture Techniques NOTES Endoscopy Minimally invasive surgery Suturing Bladder Science & Technology |
title_short |
Endoscopic closure of transmural bladder wall perforations |
title_full |
Endoscopic closure of transmural bladder wall perforations |
title_fullStr |
Endoscopic closure of transmural bladder wall perforations |
title_full_unstemmed |
Endoscopic closure of transmural bladder wall perforations |
title_sort |
Endoscopic closure of transmural bladder wall perforations |
author |
Lima, Estêvão Augusto Rodrigues de |
author_facet |
Lima, Estêvão Augusto Rodrigues de Rolanda, Carla Osório, Luís Pêgo, José M. Silva, David Henriques-Coelho, Tiago Carvalho, José L Bergström, Maria Park, Per-Ola Mosse, Charles A. Swain, Paul Correia-Pinto, Jorge |
author_role |
author |
author2 |
Rolanda, Carla Osório, Luís Pêgo, José M. Silva, David Henriques-Coelho, Tiago Carvalho, José L Bergström, Maria Park, Per-Ola Mosse, Charles A. Swain, Paul Correia-Pinto, Jorge |
author2_role |
author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Lima, Estêvão Augusto Rodrigues de Rolanda, Carla Osório, Luís Pêgo, José M. Silva, David Henriques-Coelho, Tiago Carvalho, José L Bergström, Maria Park, Per-Ola Mosse, Charles A. Swain, Paul Correia-Pinto, Jorge |
dc.subject.por.fl_str_mv |
Animals Cystoscopy Cystotomy Feasibility Studies Female Iatrogenic Disease Pilot Projects Rupture Rupture, Spontaneous Swine Treatment Outcome Urinary Bladder Wounds, Penetrating Suture Techniques NOTES Endoscopy Minimally invasive surgery Suturing Bladder Science & Technology |
topic |
Animals Cystoscopy Cystotomy Feasibility Studies Female Iatrogenic Disease Pilot Projects Rupture Rupture, Spontaneous Swine Treatment Outcome Urinary Bladder Wounds, Penetrating Suture Techniques NOTES Endoscopy Minimally invasive surgery Suturing Bladder Science & Technology |
description |
Background: 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. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-07 2009-07-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/67597 |
url |
http://hdl.handle.net/1822/67597 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0302-2838 10.1016/j.eururo.2008.06.010 18571311 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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