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Chapter-36 Bladder and Ureteric Injuries at Laparoscopy

BOOK TITLE: Textbook on Complications in Gynecological Surgery

Author
1. Sabnis Aneesh
ISBN
9788180617140
DOI
10.5005/jp/books/10963_36
Edition
1/e
Publishing Year
2006
Pages
10
Author Affiliations
1. Sneh Nursing Home and Centre for Gynecological Endoscopic Surgery, Andheri (E), Mumbai
Chapter keywords
Bladder injury, Ureteric injury, Laparoscopy, Cystoscopy, Stent, Thermal injury, Ischemia, Ligation, Resection, Transaction, Angulation, Hydronephrosis, Leak, Stenosis, Uremia, Re-anastomosis, Punction, Bladder tear, Intravenous pyelography, Cauterization, Catheterisation, Reimplantation

Abstract

Case histories of ureteric injuries following laparoscopic injuries are described, where the injuries could be treated with the use of ureteric stents placed cystoscopically. Anatomy of the ureter is described, from its origin, to the entry into the bladder. Predisposing factors for ureteric injury are highlighted. Types of operative trauma, viz, thermal, ischemic, ligation, transection, resection, and angulation, are enumerated. Bladder injuries, caused by ischemia, incision, and puncture, are described. Anatomical locations of injuries are mentioned. Sequel of injuries, starting with spontaneous resolution, going through hydronephrosis, leak, stenosis and uremia are described. Tips are given to prevent injuries. Management principles of surgical correction of ureteric and bladder injuries are given. Surgical technique of ureteric reanastomosis is described. Guidelines are given on the timing of surgical correction.

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