Vascular injuries during gynecological laparoscopy--the vascular surgeon's advice.
BACKGROUND
Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services.


METHODS
Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period.


CONCLUSIONS
Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.
Barbosa Barros
Marcello
M
Vascular Surgery Department, University Hospital of Salamanca, Spain. marcellobb@bol.com.br
Lozano
Francisco S
FS
Queral
Luis
L
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007083:Iliac Artery / Q000293:injuries* / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy