Abstract
Thirty-one (31) cases with 49 major-vessel injuries associated with laparoscopic surgery are reported. Women with body mass indices ≥ 25-30 kg/M2 accounted for 22 of 31 cases. Ninety percent (90%) of vascular injuries in this study were associated with the use of disposable trocar devices. Although injuries to arteries and veins were approximately equal, the 7/31 (23%) fatalities all involved predominantly venous damage. Three (3) of the seven (7) deaths related to the use of extra-long trocar insertion. Collateral injuries happened at the time of the initial vascular injury or occurred as a complication during the repair of the primary vascular problem in 16 cases. The latter included urinary, gastrointestinal, neurologic, hematologic, and circulatory complications. Several inappropriate actions taken by the gynecologist are quantified. Large-vessel penetration during gynecologic laparoscopy is a bona fide emergency and requires timely diagnosis and proper remedial measures leading to precise restoration.
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