title: Right diaphragm injury: an unusual complication in single-port laparoscopic cholecystectomy.
abstract: Laparoscopic cholecystectomy (LC) is nowadays the standard method for cholecystectomy. Recently, surgeons attempt to introduce even less-invasive surgical procedures, such as single-port LC or LC through natural orifice transluminal endoscopic surgery (NOTES). The number of studies showing the feasibility of these techniques increased during the last years, but specific complications that correlated with these new techniques are still not apparent. Here, we report on a case with an unusual complication, iatrogenic right diaphragm injury in single-port LC. A 72-year-old man underwent single-port LC because of symptomatic cholecystolithiasis. During the operation, the long rigid straight forceps holding the fundus of the gallbladder slipped off toward the right diaphragm and caused a 1-cm full-thickness diaphragmatic tear. Laparoscopic suture repair was performed, and the patient recovered uneventfully. In using long forceps in single-port LC or transvaginal NOTES-LC, reticulating and bent instruments may avoid this unusual but possible complication in these operations.
authors.affiliation: Department of General Surgery, Clinic Gummersbach, Germany.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Hosogi
authors.forename: Philipp
authors.initials: P
authors.lastname: Lingohr
authors.forename: Thomas
authors.initials: T
authors.lastname: Galetin
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
authors.forename: Stefan
authors.initials: S
authors.lastname: Saad
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000293:injuries*; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D020706:Laparoscopes; D008297:Male; D013536:Suture Techniques