Controlled balloon dilatation for laparoscopic extraperitoneal bladder neck suspension in patients with previous abdominal surgery
Froeling, F M × Deprest, Jan Ankum, W M Mendels, E L Meijer, D W Bannenberg, J #
Journal of laparoendoscopic & advanced surgical techniques. Part A vol:10 issue:1 pages:27-30
PURPOSE: The balloon dilator is used in a variety of minimally invasive preperitoneal and retroperitoneal operations. In this study, we compared the ability to create an extraperitoneal cavity using a balloon spacer in patients with and without previous abdominal surgery undergoing laparoscopic bladder neck suspension. PATIENTS AND METHODS: This prospective study included 38 patients in total, 15 of whom had had previous abdominal wall surgery and 23 who had not. A balloon spacer technique was used to develop the extraperitoneal space. RESULTS: In 80% of the patients with previous surgery, the introduction of the balloon spacer was recorded as simple; in 20%, it was considered difficult. In 78% of the patients without previous surgery, the introduction of the balloon spacer was recorded as simple, in 17% it was difficult, and in 4% it failed. In 80% of the patients with previous surgery, the extraperitoneal view was good or acceptable, in 20% it was poor, and in 13% it failed. In 92% of the patients without previous surgery, the extraperitoneal view was good or acceptable, in 4% it was poor, and in 4% dilatation failed. Morbidity was equally divided between the groups. CONCLUSIONS: Previous abdominal surgery is not a contraindication to laparoscopic extraperitoneal surgery using a balloon spacer. The approach carries low morbidity, similar to that in patients without previous abdominal surgery.