title: Vascular complications in minimally invasive surgery.
abstract: Injuries to major vessels in the course of laparoscopic surgery are rare but serious, life-threatening complications. We report nine iatrogenic vascular injuries during minimally invasive surgery that occurred between January 1991 and December 1995 in surgical and obstetric-gynecologic services in the Austrian province of Styria. The total vascular complication rate is 0.08%. As these data show, the distal abdominal aorta and vena cava, as well as the large pelvic vessels, are especially susceptible to injury when the Veress needle and trocars are inserted into the abdomen. Surgical reconstruction of these eight arterial lesions required a polytetrafluorethylene (PTFE) patch in one case, and the resection of the damaged section of the artery and reanastomosis in two others. The remaining lesions, as well as an isolated vein injury, were corrected with direct suturing of the vessel. Pelvic circulation was completely restored in all patients, and permanent damage was avoided.
authors.affiliation: Department of Vascular Surgery, Karl Franzens University Graz, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Fruhwirth
authors.forename: G
authors.initials: G
authors.lastname: Koch
authors.forename: H J
authors.initials: HJ
authors.lastname: Mischinger
authors.forename: G
authors.initials: G
authors.lastname: Werkgartner
authors.forename: N P
authors.initials: NP
authors.lastname: Tesch
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001012:Aorta, Abdominal / Q000293:injuries* / Q000601:surgery; D001317:Austria; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007083:Iliac Artery / Q000293:injuries* / Q000601:surgery; D007084:Iliac Vein / Q000293:injuries / Q000601:surgery; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D009339:Needles / Q000009:adverse effects; D010388:Pelvis / Q000098:blood supply; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012039:Regional Blood Flow; D013536:Suture Techniques; D014684:Venae Cavae / Q000293:injuries
chemical_list: D011138:Polytetrafluoroethylene