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.

Minimally Invasive Stethoscopic Suture Excision

Metro Health Medical Center

bladder stitch removal

laparoscopic surgeries

urinary urgency