Injuries to major blood vessels during laparoscopy

Abstract

Major blood vessel injury is a true emergency during laparoscopic procedures. Too often, the act or fear of litigation quashes the opportunity to assess the cause and learn from the experience of others. Frequently, only through a medicolegal review can such events be evaluated. After reviewing 40 such cases, the following lessons were learned. Proper technique when inserting the Veress needle, laparoscopic cannulas, and open cannulas can prevent most such accidents. If the standard precautions during insertion are breached, safety shields on disposable cannula sleeves do not prevent or reduce the risk of major vessel injury. Retroperitoneal hematomas require exploratory laparotomy for proper assessment. Distorted anatomy or steep Trendelenburg position may increase the risk of vessel injury. Dissections around the great vessels of the pelvis require the same methods and precautions as with laparotomy.

A novel method for artery detection in laparoscopic surgery

“…The primary operations were cholecystectomy in seven patients and appendectomy in one patient. Through a medicolegal review, Soderstrom [4,5] reported 40 major blood vessel injuries during laparoscopic procedures and 47 during endoscopic procedures. Moreover, distinguishing arteries from veins is necessary in all surgical cases [6].…”

A retrospective study of a novel non-umbilical laparoscopic entry port in thin patients—Jain point

“…According to this study, considering that open technique totally eliminates the risk of MVI as was made to believe, seems inaccurate and can create catastrophic complications as well [30]. Even cases of MVI have been reported with open Hasson technique which occurred during the skin knife incision that lacerated the aorta [6,23,30,31] and that is a major concern for slender patients [32].…”

Laparoscopy: reasons for conversion to laparotomy in the Department of Gynecology, Institute of Polish Mother’s Memorial Hospital in Lodz in the years 2006-2012

“…laparoskopii otwartej (open laparoskopy). Po inspekcji jamy otrzewnej, w zależności od warunków anatomicznych i zakresu planowanego zabiegu instaluje się od 1 do 3 trokarów roboczych [1][2][3].…”