Ureteral Injury Due to a Harmonic Scalpel During Laparoscopic Salpingo-oophorectomy

Vetere, Patrick F.; Apostolis, Costas

doi:10.4293/108680810x12674612014987

Cited by 17 publications

(10 citation statements)

References 12 publications

(24 reference statements)

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“…There are various reports of successful laparoscopic procedures using ultrasonic energy devices. This includes gynecological [45–48], laparoscopic cholecystectomy [49–51], laparoscopic appendectomy [52], laparoscopic myomectomy [53, 54], laparoscopic colorectal [55], laparoscopic salpingo-oophorectomy [56] and laparoscopic management of cornual heterotopic pregnancy [57]. Ultrasonic scalpel (Harmonic ACE) was also successfully used in division of pulmonary vessels in video assisted lung resection [58].…”

Section: Methodsmentioning

confidence: 99%

Common uses and cited complications of energy in surgery

et al. 2013

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Background Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality. The current article reviews various energy sources in terms of their common uses and safe practices. Methods For the purpose of this review, a general search was conducted through NCBI, SpringerLink and Google. Articles describing laparoscopic or minimally invasive surgeries using a single or multiple energy sources are considered, as are the articles comparing various commercial energy devices in laboratory settings. Keywords such as ‘laparoscopy’, ‘energy’, ‘laser’, ‘electrosurgery’, ‘monopolar’, ‘bipolar’, ‘harmonic’, ‘ultrasonic’, ‘cryosurgery’, ‘argon beam’, ‘laser’, ‘complications’, and ‘death’ were used in the search. Results and Conclusion A review of the literature shows that the performance of the energy devices depends upon the type of procedure. There is no consensus as to which device is optimal for a given procedure. The technical skill level of the surgeon and the knowledge about the devices are both important factors in deciding safe outcomes. As new energy devices enter the market increases, surgeons should be aware of their indicated use in laparoscopic, endoscopic and open surgery.

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Section: Methodsmentioning

confidence: 99%

Common uses and cited complications of energy in surgery

et al. 2013

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“…Another possible mechanism is that the appendiceal artery was indirectly affected by secondary thermal injury during harmonic dissection of the mesenteric lesion. Whilst uncommon, unexpected thermal injuries to surrounding structures have been reported during use of Harmonic dissection 7 .…”

Section: Discussionmentioning

confidence: 99%

Case Report: Ischaemic appendicitis post mesenteric biopsy

2016

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A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach. There are no reports to date of ischaemia to the appendix as a complication of this procedure. We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis.

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“…This vapor may have dissected tissue planes and traveled to the ureter. 5 Prior ureteric catheterization may help in preventing injuries in high risk cases, but it may not be easy in cases like in big myomas. Side effects like lower backache and hematuria occur frequently in most patients.…”

Section: Discussionmentioning

confidence: 99%

“…4 Another interesting case report by Vetere et al demonstrated the versatility of HS to do a salpingo-oophorectomy of a complex ovarian mass on one side but it caused a ureteral fistula while doing salpingo-oophorectomy on the normal side in the same patient. 5 HS related ureteral injuries are usually energy induced or by devascularization. It can lead to ureterovaginal fistulas or strictures in the lower 1/3rd of ureter.…”

Section: Discussionmentioning

confidence: 99%

Ureterovaginal Fistula after Use of Harmonic Scalpel in Total Laparoscopic Hysterectomy: Possible Causes and Successful Management

De¹,

Sharma²

2014

Journal of SAFOMS

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We report a case of a woman presenting with continuous dribbling of urine since her total laparoscopic hysterectomy with harmonic scalpel three months back. A clinical examination, three swab test and IVP confirmed a left sided uretrovaginal fistula. A ureteroneocystostomy was done and she recovered full bladder control. In this case we try to find the reasons and the finer points of harmonic use to prevent such an injury.

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Ureteral Injury Due to a Harmonic Scalpel During Laparoscopic Salpingo-oophorectomy

Abstract: This report highlights the need for vigilance when using laparoscopic energy sources and suggests surgeons who use the Harmonic scalpel pay close attention to application times during tissue dissection.

Cited by 17 publications

References 12 publications

Common uses and cited complications of energy in surgery

Common uses and cited complications of energy in surgery

Case Report: Ischaemic appendicitis post mesenteric biopsy

Ureterovaginal Fistula after Use of Harmonic Scalpel in Total Laparoscopic Hysterectomy: Possible Causes and Successful Management

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