What is a trocar injury?
A trocar is a surgical instrument that is often used for withdrawing fluid and is inserted in the abdomen during laparoscopic surgery. Trocar injuries are commonly the result of people’s internal organs being too close to the point of trocar insertion or the trocar penetrating too far into the abdominal cavity.
What is the more frequent location of major vessel injury during umbilical trocar insertion?
Major vascular injury can occur when the Veress needle is inserted prior to insufflation or when a trocar is inserted after insufflation. The reason for these injuries is the close proximity of the anterior abdominal wall to the retroperitoneal vascular structures.
What is a trocar site hernia?
Abstract. Trocar site hernia (TSH) is an incisional hernia occurring at the trocar insertion sites after different types of laparoscopic surgeries. The aim of this study is to present characteristics of patient and surgery series with trocar site hernia after laparoscopic cholecystectomy.
Can a laparoscopy cause bowel problems?
Large bowel injuries during laparoscopy are serious complications because 50% of bowel injuries and 60% of visceral injuries are undiagnosed at the time of primary surgery. A missed or delayed diagnosis increases the risk of bowel perforation and consequently sepsis and even death.
What complications are associated with co2 insufflation?
The 4 major pulmonary complications that can occur with abdominal insufflation include hypercarbia, hypoxemia, reduction in pulmonary compliance, and subcutaneous emphysema. Hypercarbia can cause systemic vasodilatation, arrhythmias, myocardial depression, and exacerbation of pulmonary hypertension.
How do you use Hasson trocar?
The open technique was first described by Hasson in 1970. This technique consists of creating a small umbilical incision under direct visualization to enter the abdominal cavity followed by the introduction of a blunt trocar. Pneumoperitoneum is then rapidly created.
How many trocar injuries are there in the US?
Manufacturers are required to report medical device-related incidents to the Food and Drug Administration. We analyzed the 629 trocar injuries reported from 1993 through 1996. There were three types of injury: 408 injuries of major blood vessels, 182 other visceral injuries (mainly bowel injuries), and 30 abdominal wall hematomas.
What causes a trocar injury in laparoscopic surgery?
Retroperitoneal vascular injuries should be largely avoidable by following safe techniques. Bowel injuries often went unrecognized, in which case they were highly lethal. Device malfunction was rarely a cause of trocar injuries. Trocar injury is one of the most serious, potentially preventable complications in laparoscopic surgery.
When do you have to report a trocar injury?
Manufacturers and users are required to report medical device-related incidents to the Food and Drug Administration (FDA), whose records through 1996 are available on the Internet. In this study we analyzed all reported complications from laparoscopic trocars in the period 1993 to 1996.
How are trocars used to treat vascular injuries?
Abstract. Eighty-seven percent of deaths from vascular injuries involved the use of disposable trocars with safety shields and 9% involved disposable trocars with a direct-viewing feature. The aorta (23%) and inferior vena cava (15%) were the vessels most commonly traumatized in the fatal vascular injuries.