Method of performing a suprapubic transurethral cystostomy

A method of forming a surgical opening through an abdominal wall from a bladder using a suprapubic transurethral cystotomy apparatus, the cystostomy apparatus comprising an elongate tubular body and an advancement member and an alignment structure, the tubular body having a proximal portion and a distal portion extending along a linear axis, the advancement member movably positioned to move from the tubular body, the alignment structure connecting to the proximal portion of the tubular body and having an indicator which indicates the linear axis from the distal portion of the tubular body, the method comprising:

• inserting the distal portion of the tubular body through a urethra and into the bladder while the proximal portion of the tubular body and the connected alignment structure remain outside of the urethra;
• locating the indicator externally over the abdominal wall in coaxial alignment with the linear axis;
• manipulating the proximal portion of the tubular body outside of the urethra to position a distal tip of the distal portion at a predetermined location within the bladder at which the surgical opening will communicate with the bladder;
• advancing the advancement member from the distal portion of the tubular body along the linear axis while the distal tip is positioned at the predetermined location to form the surgical opening through the abdominal wall between the distal tip and the indicator;
• and
• indicating with the indicator the position of the linear axis at the external abdominal wall by maintaining the indicator located in coaxial alignment with the linear axis as the advancement member advances from the distal tip through the abdominal wall to form the surgical opening.

A method of forming a surgical opening extending through an abdominal wall and a bladder, comprising:

• inserting a cutting member through a urethra and into the bladder to a predetermined location within the bladder at which the surgical opening will communicate with the bladder;
• establishing a linear axis from the cutting member through the abdominal wall along which the surgical opening will extend when formed;
• manipulating an indicator externally above the abdominal wall to a predetermined location at the exterior abdominal wall where the surgical opening will extend through the external abdominal wall;
• maintaining the indicator in a coaxial relationship with the linear axis while manipulating the cutting member and forming the surgical opening;
• advancing the cutting member from the predetermined location within the bladder along the linear axis through the abdominal wall to the indicator to form the surgical opening;
• and
• indicating with the indicator the position of the linear axis on the external abdominal wall while maintaining the indicator in the coaxial relationship with the linear axis as the cutting member advances through the abdominal wall.