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PFD Week 2017
Minimally Invasive Cystoscopic Suture Excision
Minimally Invasive Cystoscopic Suture Excision
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Video Transcription
The title of this video is Minimally Invasive Stethoscopic Suture Excision. This video was produced at Metro Health Medical Center in Cleveland, Ohio. The authors do not have any disclosures. The purpose of this video is to demonstrate a simplified approach to removal of a bladder stitch. The case presented is of a 40-year-old G3P3 with a history of endometriosis, pelvic organ prolapse, and stress incontinence. She underwent a total laparoscopic hysterectomy with retropubic sling and laparoscopic uterocyclic ligament suspension using two ether bond sutures. Stethoscopy was normal at the end of the procedure. The left pelvic side wall appeared inflamed and colorectal surgery was consulted. Three months postoperatively, the patient underwent a sigmoid resection. This was complicated by a cystotomy, which was repaired by a mini-laparotomy. Stethoscopy revealed a normal bladder with a watertight closure. During recovery and for the next several months, the patient complained of urinary urgency and frequency and subsequently failed a trial of anticholinergic medication. She then underwent an in-office stethoscopic evaluation revealing what appeared to be an ether bond suture. Stethoscopic findings confirmed the in-office evaluation. A laparoscopic fascial closure device is then introduced suprapubically and through the dome of the bladder. Traction is applied to the suture and the knot is then visualized. The suture is then cut. A grasper is then used to deliver the suture transurethrally. The instruments used to perform this procedure included a 30-degree stethoscope with grasper and scissors and a laparoscopic fascial closure needle.
Video Summary
In this video titled "Minimally Invasive Stethoscopic Suture Excision," produced at Metro Health Medical Center, the authors demonstrate a simplified approach to removing a bladder stitch. The patient in the case had a history of endometriosis, pelvic organ prolapse, and stress incontinence, and had undergone laparoscopic surgeries. Months later, she experienced urinary urgency and frequency and an in-office evaluation revealed the presence of a suture. Using a laparoscopic fascial closure device, the suture was visualized and cut, and then delivered transurethrally. The instruments used included a stethoscope with grasper and scissors, and a laparoscopic fascial closure needle. No disclosures were made by the authors.
Asset Subtitle
Robert Pollard, MD
Keywords
Minimally Invasive Stethoscopic Suture Excision
Metro Health Medical Center
bladder stitch removal
laparoscopic surgeries
urinary urgency
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