Safe Laparoscopy =
Enjory the Advantages
Avoid the Complications
Complications of laparoscopy
I - Due to pneumo-peritoneum:
1- Surgical emphysema:
Subcutaneous, scrotal, pre-peritoneal, retroperitoneal, omental, mesenteric and mediastinal.
2- Pneumothorax:
Diaphragmatic or pleural injury
Patent pleuro-peritoneal canal.
3- Air Embolism
4- Increase venous return
à Hypotension + D.V.T.
5- Hypercarbia à arrhythmia and acidosis.
6- Increase diaphragmatic movements.
7- Spread of malignancy à port metastasis .
8- Spread of infection to surgeon-conjumctiva
II - Visceral injuries (0.16 – 0.27%)
Solid organ or hollow viscous.
Complete or incomplete.
Etiology:
Lack of relaxation.
Forcible introduction of trocar.
small trocar wound.
Full bladder and distended gut.
Adhesions to abdominal Wall.
Thermal injuries esp. monopolar.
Faulty techniques ie. sharp instruments out of field
Diagnosis:
Aspiration from veress needle.
Lap. Exploration
May be missed.
Post operative Drain.
Treatment:
Prophylaxis.
Early recognition.
Repair (Lap. Or open).
NB.
Abnormal unexplained blood or fluid inside the peritoneum = ?? Injury