The Vascular Injuries During Laparoscopic Surgery

Kim, Kyung Sik; Kang, Jung Ku; Kim, Suk Ju; Lee, Woo Jung; Kim, Byong Ro

Abstract

Laparoscopic procedures have been accepted as a safe, effective treatment modalities and are well tolerated by patients. Although incidences of major vascular injuries following laparoscopic procedures are rare, they are important in that they can cause serious morbidity or death. From February 1993 to November 1996, we experienced 3 cases of vessel injury during laparoscopic surgery. In the first case, the right hepatic artery was injured during a laparoscopic cholecystectomy. We converted to open surgery immediately. The second case involved a scrotal hematoma which developed immediately after a transabdominal preperitoneal(TAPP) laparoscopic hernia repair. We opened the inguinal region anteriorly 2 days after the surgery and confirmed the bleeding from the inferior epigastric artery. In the third case, the left common iliac artery was injured during trocar insertion for a laparoscopic appendectomy, and it was unnoticed. One hour after the operation, we had to open the abdomen due to fresh bleeding from the drainage. All three patients had no morbidity or mortality after the definite surgery. We conclude that if there is any suspicion of vascular injuries, immediate conversion to open procedures is mandatory, and appropriate vascular surgical techniques should be applied to lessen the morbidity and the mortality.