Bowel and bladder injuries are relatively rare, but there can be serious complications of both open and minimally invasive gynecologic procedures. As with most surgical complications, timely recognition is key in minimizing serious patient morbidity and mortality. Diagnosis of such injuries requires careful attention to surgical entry and dissection techniques and employment of adjuvant diagnostic modalities. Repair of bowel and bladder may be performed robotically, laparoscopically, or using laparotomy. Repair of these injuries requires knowledge of anatomic layers and suture materials and testing to ensure that intact and safe repair has been achieved. The participation of consultants is encouraged depending on the primary surgeon’s skill and expertise. Postoperative care after bowel or bladder injury requires surveillance for complications including repair site leak, abscess, and fistula formation.
Complex gynecologic surgery requires a thorough understanding of the diagnosis, repair, and perioperative management of visceral injuries.
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Corresponding author: Laura M. Glaser, MD, 250 E Superior, Suite 03-2303, Chicago, IL 60611; email: l-matthews@northwestern.edu.
Supported by the Albert B. Gerbie Professorship Fund.
Financial Disclosure The authors did not report any potential conflicts of interest.
Each author has confirmed compliance with the journal’s requirements for authorship.
Received April 24, 2018
Received in revised form June 14, 2018
Accepted June 28, 2018
