Unrecognized bladder perforation during operative laparoscopy.

During operative laparoscopy in a 42-year-old woman, 12-mm trocar lacerations occurred through anterior and posterior walls of the bladder but were not recognized. This case demonstrates important issues related to predicting, avoiding, detecting, and treating bladder trauma associated with laparoscopic surgery. It also indicates that some classic warning signs of accidental cystotomy may be absent or delayed in appearance.