Prevention and Treatment of Abdominal Wall Bleeding Complications at Trocar Sites

Vázquez-Frias, José Antonio; Huete-Echandi, Federico; Cueto-Garcia, Jorge; Padilla-Paz, Luis Alfonso

doi:10.1097/sle.0b013e3181a620dc

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…Although trocar-related injury is uncommon, it is enough of a problem that various methods of prevention and treatment are still being investigated 10, 11. When ancillary ports are inserted, it increases the risk of injury to the inferior epigastric vessels 12.…”

Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Salpingectomy for Surgical Treatment of Tubal Pregnancy: Comparison with Multi-Port Laparoscopic Salpingectomy

Kim¹,

Park²,

Kim³

et al. 2013

Int. J. Med. Sci.

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BackgroundThis study investigates the safety and feasibility of transumbilical single-port laparoscopic salpingectomy (SPLS) using conventional laparoscopic instruments compared to conventional multi-port laparoscopic salpingectomy (MPLS) for surgical treatment of tubal pregnancy.Material and methods We conducted a retrospective analysis of 63 patients with tubal pregnancy who underwent SPLS and 71 patients who underwent conventional MPLS between January 2008 and December 2010. All patients in the SPLS group had a drainage tube placed through the umbilicus, and, in the MPLS group, through a 5-mm trocar site in one side of the lower abdomen.Results No significance difference was discovered between the groups with regard to adjusted hemoglobin values (SPLS, 1.9 ± 1.0 g/dL versus MPLS, 1.7 ± 1.0 g/dL, P = 0.335). Additionally, there was also no significant difference in clinical characteristics, intraoperative findings, or operative outcomes.Conclusions Our study demonstrated that transumbilical SPLS using conventional laparoscopic instruments has operative outcomes comparable to MPLS for the surgical treatment of tubal pregnancy. Transumbilical SPLS may therefore be offered as a feasible alternative to MPLS.

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Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Salpingectomy for Surgical Treatment of Tubal Pregnancy: Comparison with Multi-Port Laparoscopic Salpingectomy

Kim¹,

Park²,

Kim³

et al. 2013

Int. J. Med. Sci.

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“…Vascular anatomy of the abdominal wall was studied in many human cadavers but with wide variation in results [13]. A zone of approximately 4-8 cm away from the midline is named the dangerous zone for abdominal wall vascular injuries [12, 13] but Saber et al .…”

Section: Discussionmentioning

confidence: 99%

“…A zone of approximately 4-8 cm away from the midline is named the dangerous zone for abdominal wall vascular injuries [12, 13] but Saber et al . [14] in a study on abdominal and pelvic CT images of 100 patients found that “The average distance of the epigastric vessels from the midline for both left and right sides is consistently higher for older patients and those with body mass index more than or equal to 26.3 in all sections”.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy.

Mohammadhosseini¹,

Shirani²

2011

Videosurgery and Other Miniinvasive Techniques

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Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascular injury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at this first step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followed later by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy was needed to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocar insertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertion and entering the abdominal cavity at a right angle may decrease the possibility of this complication.

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“…In morbid obese patients undergoing bariatric surgery, control of the bleeding requires enlargement of the incision and placement of deep sutures, which is technically complicated because of the deep location of the haemorrhage source; at the ends, it leads to larger wounds, associated with more postoperative pain, an increased risk of wound infections and ugly scars. When the bleeding is not completely stopped, it can lead to haematoma formation and even massive haemoperitoneum [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Use of Foley’s Catheter to Control Port-Site Bleeding in Bariatric Surgery

2011

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Abdominal wall bleeding in the port-site insertion placed during laparoscopic bariatric surgery is often difficult to control. From January 2005 to August 2011, 226 patients underwent bariatric surgery at our institutions. Seventeen patients (7.5%) presented port-site bleeding that could not be controlled with electrocautery and Foley's catheter (24 F) was used for bleeding inhibition. Of the 17 patients, there were 12 females (70.6%) and five males (29.4%) with a mean age of 38.35 years. Mean body mass index (BMI) was 44.2. Most of bleeding port-sites were located in hypochondrium and were 12-mm size. After the catheter removal (median 36 h), bleeding did not recur in any case. There were no other complications related to the port-side bleeding and the Foley catheter placement. Hospital stay was not prolonged due to the use of the Foley catheter. Port-site bleeding in bariatric surgery is a frequent complication. In up to 7.5% of the cases, the haemorrhage cannot be controlled with electrocautery. Compression with Foley catheter balloon is a safe and efficient method to stop bleeding.

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Prevention and Treatment of Abdominal Wall Bleeding Complications at Trocar Sites

Cited by 12 publications

References 19 publications

Single-Port Laparoscopic Salpingectomy for Surgical Treatment of Tubal Pregnancy: Comparison with Multi-Port Laparoscopic Salpingectomy

Single-Port Laparoscopic Salpingectomy for Surgical Treatment of Tubal Pregnancy: Comparison with Multi-Port Laparoscopic Salpingectomy

Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy.

Use of Foley’s Catheter to Control Port-Site Bleeding in Bariatric Surgery

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