are a known complication of gynecologic procedures that involve mobilizing the bladder flap off the uterus, cervix, and vagina.
There was one complication in the robotic group (a retained asepto bulb due to miscommunication among the surgical team), and two complications in the total laparoscopic group--both cystotomies
entail a ventral midline incision as this approach provides optimal exposure of the bladder.
, both of which occurred during vaginal hysterectomy, were diagnosed and treated intraoperatively.
We have successfully corrected cystotomies
that were small, did not encroach on the ureter, and were easily repaired without tension--and we have seen no fistula formation as a result.