title: Trocar in conventional laparoscopic and robotic-assisted surgery as a major cause of iatrogenic trauma to the patient.
abstract: All laparoscopic procedures, laparoscopic or robotic-assisted, start with a trocar entry. Unfortunately unknown to most, this is an extremely important part of the surgery, as 80% of major vascular injuries and 50% of intestinal injuries occur during this procedure. Laparoscopic first entry is often delegated to trainees with little experience, wrongly assuming that laparoscopic entry is similar to incisional entry at laparotomy. This may result in patient death (mortality of major vascular injuries is 11% and unrecognized intestinal injuries is 5%) or significant temporary or permanent morbidity.
authors.affiliation: Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA; Surgical Oncologist, Sírio - Libanês Hospital, São Paulo, SP 01308-050, Brazil. Electronic address: joaosiufi@me.com.
authors.forename: Joao
authors.initials: J
authors.lastname: Siufi Neto
authors.affiliation: Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA; Surgical Oncologist, Sírio - Libanês Hospital, São Paulo, SP 01308-050, Brazil.
authors.forename: Daniela Freitas
authors.initials: DF
authors.lastname: Santos Siufi
authors.affiliation: Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
authors.forename: Javier F
authors.initials: JF
authors.lastname: Magrina
mesh_terms: D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D009852:Omentum / Q000293:injuries; D010537:Peritoneum / Q000293:injuries; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D013530:Surgical Wound Infection / Q000209:etiology; D000267:Tissue Adhesions / Q000150:complications; D014950:Wounds, Penetrating / Q000209:etiology*
keywords: first trocar entry; trocar injuries