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Chapter-28 Trocar Injuries

BOOK TITLE: Textbook on Complications in Gynecological Surgery

Author

1. Seidman Daniel S
2. Cohen Shlomo
3. Setton Ariella Jakobson

ISBN

9788180617140

DOI

10.5005/jp/books/10963_28

Edition

1/e

Publishing Year

2006

Pages

Author Affiliations

1. Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Israel, The Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Hashomer, Tel-Aviv University, Tel-Aviv, Israel, The Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine Tel-Hashomer, Tel-Aviv University, Tel-Aviv Israel, Chaim Sheba Medical Center, Tel-Hashomer and Sackler, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel, Chaim Sheba Medical Center, Tel-Hashomer, Israel, Sheba Medical Center, Tel-Hashomer, 52621, Affiliated with Tel-Aviv University, Israel., Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel, Chaim Sheba Medical Center, Tel-Hashomer; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, Israeli Society of Contraception and Reproductive Health; Chaim Sheba Medical Center, Is
2. Sheba Medical Center, Tel-Hashomer, 52621, Affiliated with Tel-Aviv University, Israel
3. Sheba Medical Center, Tel-Hashomer, 52621, Affiliated with Tel-Aviv University, Israel

Chapter keywords

Trocar, Laparoscopy, Verres, Pneumoperitoneum, Transillumination, Bowel injury, Vessel injury, Gas embolism, Bladder injury, Incisional hernia, Emphysema

Abstract

Abstract

Relative contraindications of laparoscopy, like morbid obesity, severe adhesions, previous abdominal operations, cancer, abdominal hernia, pregnancy, etc. are enumerated. Importance of gastric and bladder emptying is emphasized. Correct method for positioning the patient is described. Methods of inserting primary trocars and accessory trocars are described. Methods of avoiding injury to inferior epigastric vessels, by transillumination of abdominal wall, visualizing the vessels laparoscopically, putting a 22 gauge spinal needle before trocar insertion, are described. Trocar insertion complications to gastrointestinal organs, great vessels, abdominal wall vessels, and intraperitoneal vessels are described. Gas embolism following vessel injury is described. Bladder injuries following trocar insertion is discussed. Delayed complications like Incisional hernia, wound dehiscence, and emphysema are described.

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