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A significant minority of patients with systemic lupus erythematosus (SLE) have detectable heart murmurs that may predispose them to infective endocarditis following dental and other invasive medical procedures. SLE is an autoimmune disease that sometimes causes heart valve abnormalities. Valve disease increases the risk of heart infections following procedures which might introduce bacteria into the bloodstream, such as dental cleaning and surgery. Researchers reviewed the medical charts of 275 SLE patients, and found that 19% had a heart murmur indicating a possible valve defect. About 4% of these patients had valve defects, and might benefit from antibiotics during invasive procedures.

Background: The aim of this report is to describe our surgical technique for robot-assisted laparoscopic bladder diverticulectomy. In this technique, methylene blue is instilled into the bladder to aid in intra-abdominal identification of the diverticular neck. Subjects and Methods: We retrospectively reviewed the records of patients who underwent robot-assisted bladder diverticulectomy by a single surgeon. Results: Between September 2008 and January 2011, 5 patients successfully underwent robot-assisted laparoscopic bladder diverticulectomy using 1% intravesical methylene blue. All cases were completed without intraoperative complication or need for open conversion. Mean operative time was 216 minutes, with a mean estimated blood loss of 45 mL. Patients were discharged 1-2 days following surgery. No patient experienced a perioperative complication. Conclusions: The robot-assisted approach for bladder diverticulectomy is a viable alternative to both open and laparoscopic surgery. The use of intravesical methylene blue greatly aids in identification of the diverticular neck during this procedure. [ABSTRACT FROM AUTHOR]