V9-04: One-stage transvesical laparoendoscopic single-site surgery (T-LESS) for removal of two bladder diverticula in a female patient.
Bladder diverticula are usually encountered in males, and they are a rarity in women, especially in the absence of obstruction. Open surgery, as well as laparoscopic or robotic, or single-port surgery have been applied successfully to remove bladder diverticula. To the best of our knowledge, no single-port diverticulectomies have been performed in women. We present the case of using the transvesical laparoendoscopic single-port surgery (T-LESS) for excision of two bladder diverticula in a woman
In August 2016, we carried out the T-LESS access on a 67-year old woman to remove two symptomatic bladder diverticula in one session. The patient was placed in the lithotomy position and was under general anesthesia. _x000D_ The procedure was performed transvesically (percutaneous intraluminal approach) with a single-port device (Tri-Port+) via a 1.5-cm incision made 3 cm above the pubic symphysis. Standard 10-mm optic and straight laparoscopic instruments were used. The diverticula were dissected and removed from the bladder with a combination of standard laparoscopic and endoscopic instruments introduced through the TriPort+ or the urethra. The bladder wall openings were closed by running absorbable 2/0 polyglactin sutures. An 18F Foley catheter was left in place for 6 days._x000D_
The operation lasted 120 minutes. Blood loss was minimal, and no complications were observed. The postoperative period was uneventful. The patient was discharged within 18 hours of surgery. During a nine-week follow-up, the patient reported the significant improvement in the severity of symptoms. Laboratory examination results were all within the normal range.
The T-LESS procedure can be considered as a valuable option for diverticulectomies in female patients because of its minimal invasiveness, short hospital stay and fast recovery time