Cystotomy

This video demonstrates how to perform a cystotomy. An exploratory laparotomy is performed, the bladder is packed off using moistened laparotomy swabs. Stay sutures are placed in the bladder, and a full-thickness stab incision is made into the bladder lumen on the ventral surface. The incision can be extended using scissors and intraoperative suction can be used to remove urine. Extending the incision towards the bladder neck can facilitate identification of the ureterovesical junctions. The bladder is closed in a single layer using a simple continuous suture pattern. The bladder is leak-tested, and additional sutures may be placed if needed. The area is lavaged and suctioned, surgical swabs, gloves and kit are changed and the abdomen is then closed routinely.