Management of laparoscopic-related bowel injuries.
BACKGROUND
Bowel injury is an uncommon but severely hazardous complication of various laparoscopic procedures.


METHODS
Twelve cases of bowel injuries complicating different laparoscopic procedures were diagnosed or received at Ain Shams University and Menofia University hospitals over the last 3 years. The mechanism of injury was analyzed, the diagnostic methods and surgical management scrutinized, and the prognosis studied.


RESULTS
The injuries were attributed to the inadvertant introduction of Veress needles or sharp-tipped trocars or forcible undue dissection. Failure of pneumoperitoneum was implicated in two cases. Faulty judgment of the extent and site of adhesions contributed to the damage in two cases. In four cases, the duodenum was injured. The colon was perforated in six cases, and the small bowel sustained damage in two cases. Three of the patients died, all of duodenal injury. The other nine patients survived by virtue of diagnosis and proper operative management.


CONCLUSIONS
Every measure should be taken to avoid the occurrence of bowel injury during laparoscopy. Intraoperative or early postoperative diagnosis and proper management of laparoscopic-induced bowel injuries can minimize morbidity and mortality and yield a better prognosis.
El-Banna
M
M
Department of General Surgery, Ain Shams University, Building 12, Area 9, Masr Tameer, Heliopolis 11361, Cairo, Egypt.
Abdel-Atty
M
M
El-Meteini
M
M
Aly
S
S
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004564:Electrocoagulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007422:Intestines / Q000293:injuries*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011379:Prognosis