(Video Poster 34) Laparoscopic Removal of Bladder Mesh Erosion: Technique and Surgical Approach

Objectives: This video demonstrates a standardized, minimally invasive laparoscopic technique for the removal of synthetic mesh eroded into the bladder. It includes both intravesical excision and retrieval of mesh remnants from the vesicovaginal space. The goal is to provide an educational reference for surgeons managing complex mesh-related complications in urogynecology

Methods: The procedure consists of the following key steps:
• Bladder suspension for optimal exposure
• Deliberate cystotomy to access the eroded mesh
• Precise excision of intravesical mesh
• Secure two-layer bladder closure
• Dissection and clearance of the vesicovaginal space
• Complete removal of mesh remnants
• Closure of the vaginal defect at the site of mesh excision
• Interposition of an omental graft over the repair site
The technique is performed laparoscopically using standard instrumentation under direct visualization.

Clinical Relevance: Bladder mesh erosion is an uncommon yet serious complication, often presenting with recurrent urinary tract infections, haematuria, pelvic pain, and voiding dysfunction. Laparoscopic mesh excision provides a safe and effective minimally invasive alternative to open surgery, offering superior visualization and reduced morbidity. This approach facilitates comprehensive mesh removal, anatomical preservation, and improved recovery ultimately contributing to better outcomes in pelvic reconstructive surgery.