Aortic laceration during veress needle insertion: a laparoscopic disaster
- Journal of Anesthesia & Critical Care: Open Access
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Miguel Machado
Abstract
More than 50% of all complications associated with laparoscopy occur during the entry phase for pneumoperitoneum and insertion of trocars. Major vascular injuries related to blind entry technique are infrequent, occurring in 0.04–0.1% of laparoscopic procedures. Nevertheless, 13%–50% of all vascular injuries are not detected immediately during the operation, resulting in correspondingly high morbidity and mortality rates. Major vascular injuries are the second most common cause of death during laparoscopy, after death from anesthesia, with a mortality rate of 6.37 %. The first reaction after vascular injury should not be conversion to laparotomy, but instead assessment and possible control of the injury. Obesity, previous abdominal surgeries, surgical experience, inflammatory bowel disease and pelvic inflammatory disease are known risk factors to injuries during the entry phase in laparoscopy.
Keywords
Aortic laceration during veress needle insertion: a laparoscopic disaster