Introduction: Laparoscopic surgery is a safe and effective technique; however, complications must still be given serious attention. This article will discuss the severity of complications in laparoscopic surgery and preventive methods to enhance the success rate of the procedure and ensure patient safety.
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The most severe complication in laparoscopic surgery is inadvertent trocar-related injury to the retroperitoneal vessels, particularly the inferior vena cava and inferior mesenteric artery. Minor injuries can result in posterior wall hematomas, while severe injuries may lead to hemorrhagic shock and even life-threatening situations.
To prevent trocar-related injuries and their consequences, a new technique called the “safe trocar” has been developed. This trocar features an automatic valve that springs open once it breaches the abdominal wall, effectively preventing damage to the viscera and posterior wall. It is particularly suitable for patients with low body weight, thin abdominal walls, or pediatric patients.
In addition to using a safe trocar, proper control of intra-abdominal pressure is a key factor in preventing complications. By insufflating carbon dioxide to increase intra-abdominal pressure, injuries to posterior structures can be prevented. Experience also plays an important role in preventing complications. Similar incidents have occurred in some hospitals, highlighting the need for sufficient attention.
The selection of appropriate trocars and entry sites is crucial depending on individual abdominal wall conditions. Close observation is necessary when a hematoma occurs. For mild venous injuries with slow bleeding and minimal blood loss, conservative palliative therapy can be employed, allowing bleeding to stop naturally and hematoma to be absorbed.
However, if the posterior wall hematoma rapidly expands, extending to the lower limbs or pelvic wall, incising the hematoma and identifying the vessels for ligation is necessary. In cases of significant bleeding causing shock, accompanied by increased heart rate and decreased blood pressure, immediate laparotomy is required to repair the vessel, promptly restore blood flow, and avoid endangering the patient’s life.
Overall, although laparoscopic surgery is safe and effective, there is still an approximately 0.1% incidence of complications caused by trocar-related injuries. Therefore, surgeons must highly prioritize the risk of complications and take appropriate preventive measures during the procedure.
Conclusion: Preventing complications in laparoscopic surgery is crucial to ensure the success of the procedure and patient safety. Measures such as using safe trocar technology, controlling intra-abdominal pressure, selecting appropriate trocars and entry sites based on individual conditions, and closely monitoring and promptly managing hematomas can effectively reduce the risk of complications. Surgeons’ experience and professional competence are also vital factors in ensuring surgical safety. In future laparoscopic surgeries, continuous awareness improvement and preventive measures should be implemented to provide a safer surgical environment for patients.
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