The gasless laparoscopic Burch bladder neck suspension: early experience.

PURPOSE

We evaluated the gasless extraperitoneal laparoscopic Burch bladder neck suspension.

MATERIALS AND METHODS

This retrospective study included 47 patients with type II stress urinary incontinence treated sequentially with this technique between September 1994 and September 1995. Balloon dissection was used to develop the extraperitoneal space. A mechanical retraction system was used with conventional laparotomy instruments to perform laparoscopic Burch bladder neck suspension.

RESULTS

Of the 47 patients who underwent this procedure 3 (6%) required conversion to an open operation. Obesity and previous pelvic surgery were not contraindications to this technique. The only major complication involved blood loss necessitating conversion to an open operation. Average operative time was 96.4 minutes and average hospital stay was 3.5 days. Followup at 2 to 15 months (mean 8.2) indicated successful results (that is no pads were required) in 44 patients (90%).

CONCLUSIONS

Gasless laparoscopic bladder neck suspension has a lower open surgery rate, and may be performed more rapidly than conventional carbon dioxide laparoscopic Burch bladder neck suspension. Previous multiple operations and obesity are not contraindications to the technique.