Anterior vesical hitch--a step to enhance safety of percutaneous access to bladder

Abstract

Purpose: To describe the novel technique of anterior vesical hitch to enhance the efficacy and safety of percutaneous bladder surgery.

Materials and methods: The anterior bladder wall is anchored to the anterior abdominal wall with the help of a prolene suture passed slightly lateral to the midline midway between the pubic symphysis and umbilicus. Percutaneous cystolitholapaxy and antegrade posterior urethral valve ablation were performed after anterior vesical hitch in five pediatric male patients. Data collected included operative parameters and complications related to the technique.

Results: Mean patient age was 2.9 years (range 1.5-6 years). Three patients had bladder stones and two had posterior urethral valves. Mean time to achieve bilateral parietal fixation of the bladder was 7 min 20 s. There was no intraoperative slippage of Amplatz sheath or suture cut through. No bleeding from the puncture site was encountered. No postoperative complication related to the percutaneous access tract was noted in any patient.

Conclusions: The anterior vesical hitch procedure is safe and easy. It prevents slippage of Amplatz sheath during percutaneous access to the bladder lumen.