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Endometriosis Tied to Laparoscopic Complications.
ORLANDO, FLA. -- The complication rate associated with laparoscopic entry devices appears high in women with endometriosis, and trocar-related injuries are a particular problem, according to presentations made at the annual meeting of the American Association of Gynecologic Laparoscopists.
In a review of reports submitted to the Physician Insurers Association of America regarding malpractice litigation, trocars were responsible for more injuries than any other type of entry device in 293 injuries that took place during laparoscopic entry Nearly a third of all the injuries involved the small bowel, and in 36 cases there were at least two organs damaged, usually the bowel and a major blood vessel. In two cases, there were four organs injured, Dr. Stephen L. Corson reported.
The mortality rate was higher when the injury was not recognized immediately said Dr. Corson, head of the reproductive endocrinology section at Thomas Jefferson University Hospital, Philadelphia.
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LONDON -- Physicians attempting laparoscopic entry in patients who have had previous abdominal surgery...adhesions from previous surgeries are a major cause of laparoscopic entry-related complications and can lead to visceral injury...
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...trocarless cannula during closed laparoscopic entry, which may reduce major injuries...also Pneumoperitoneum). "During laparoscopic entry, the initial VIP pressure was measured...Three simple steps during closed laparoscopic entry may minimize major injuries. Surgical...
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- CLINICAL PEARLS.
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...years. Sometimes I share it rather loudly, but I always try to remember to say "please." When first learning laparoscopic entry techniques, many residents, concerned that the insufflation needle or trocar could injure the uterus, tend...
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...injuries does have some limitations. Hemodynamically unstable patients, for example, cannot tolerate the delays in laparoscopic entry into the abdomen and the pneumoperitoneum that laparoscopic procedures require. Some studies also show that certain...
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...patients) or at rest (two patients) was seen only in patients who underwent open repair. No serious laparoscopic complications were seen. Comment Laparoscopic and Lichtenstein open mesh repairs were associated with good long term...
Source: HighBeam Research, Endometriosis Tied to Laparoscopic Complications.