Figure 3-8. Trocar cystostomy.
3-24. PARTIAL CYSTECTOMY
a. General. This procedure involves the resection of a portion of the bladder
having a lesion.
b. Operative Procedure.
(1) The bladder and lesion are exposed via suprapubic abdominal, perineal,
or vaginal approach. Usually the bladder is opened suprapubically, as described in
The ureteral orifices are identified and ureteral catheters passed.
(3) The diseased portion of the bladder is excised, using clamps and
ligatures of the type required for the organs and tissues involved. Vessels are tied with
number 2-0 plain gut.
(a) For vesicointestinal fistula, bowel resection with colostomy or
ileostomy may be indicated. For vesicovaginal fistula, a vaginal plastic repair is done.
(b) For diverticulum, excision of the defect is done intravesically or
(4) The incision in the bladder is sutured in two layers, as described in