Complications of Minimally Invasive Surgery and Their Management

Kaplan, Joshua R.; Lee, Ziho; Eun, Daniel; Reese, Adam C.

doi:10.1007/s11934-016-0602-6

Cited by 20 publications

(11 citation statements)

References 63 publications

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“…Trocar puncture accidents are rare but associated to high morbidity due to viscera lesion or even mortality in cases of vascular injury. 12–14 The technique is also of some importance for safe trocar insertion, in addition to the characteristics of the trocar itself. Some systematic review compared different laparoscopic entry techniques.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Moreno

Pereira

Anna

et al. 2019

JSLS

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Background and Objective: The number of laparoscopic procedures increases annually with an estimated 3% of complications, one third of them linked to Verres' needle or trocar insertion. The safety and efficacy of ports insertion during laparoscopic surgery may be related the technique but also to trocar design. This study aims to compare physical parameters of abdominal wall penetration for 5 different trocars. Methods: Eleven pigs were studied. Five different commercially available trocars were randomically inserted at the midline. Real-time video recording of the insertions was achieved to measure the excursion of the abdominal wall and the time and distance the cutting surface of the bladed trocars was exposed inside the abdominal cavity. An especially designed hand sensor was developed and placed between the trocar and the hand of the surgeon to record force required for abdominal wall perforation. Results: Greater deformations and forces occurred in nonbladed as compared to bladed trocars, and in conical trocars as compared to pyramidal pointed ones, except for peritoneum perforation. Greater distance and time of blade exposure occurred in pyramidal laminae as compared to conical. Conclusion: The bladed trocars have lower forces and deformations in their introduction, and should be those that cause less injury and are more suitable for first entry. Conical and pyramidal trocars with the same blade size showed similar force, deformation, time, and distance of exposed blade.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Moreno

Pereira

Anna

et al. 2019

JSLS

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“…This type of injury would occur outside of the view shown on the surgical monitor, which could delay its diagnosis. Some investigators have studied organ injuries that occur during laparoscopic surgery and found that measurable injuries that are diagnosed after surgery can lead to serious morbidities 5‐7 . In general, numerous instrument insertions are performed during laparoscopic and robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

How to reduce the risk of organ injuries during surgical instrument insertion in laparoscopic surgery: Pushing/pressing force analysis using forceps with sensors

Makiyama

Osaka

Araki

et al. 2020

Asian J Endoscop Surgery

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Introduction In laparoscopic surgery, surgical instruments are inserted from a trocar to the target organ in a blind fashion, which carries a risk of organ injury. To clarify the risks associated with surgical instrument insertion, we measured grip strength and pushing/pressing force during surgical instrument insertion in laparoscopic surgery. Methods Using forceps with sensors inside a trocar, 10 urologists performed a laparoscopic procedure in pigs, in which they were asked to touch the abdominal wall. The surgeons closed their eyes during the procedure and stopped moving the forceps when they felt them come into contact with the abdominal wall. They were ordered to grip the forceps strongly or softly and to move them rapidly or slowly during the procedure. Grip strength and the pushing/pressing force when the forceps hit the abdominal wall were measured and analyzed. Results The mean pushing/pressing force when the surgeons gripped the forceps strongly and moved them rapidly (strong/rapid), strongly/slowly, softly/rapidly, and softly/slowly were 2.8, 2.0, 1.7, and 1.1 N, respectively. The pushing/pressing force was significantly greater when the surgeons gripped the forceps strongly, regardless of the forceps speed (P < .001). The pushing/pressing force was significantly greater when the surgeons moved the forceps rapidly, regardless of grip strength (P < .001). Conclusions When surgeons insert laparoscopic instruments through trocars, the instruments should be gripped softly and moved slowly to avoid organ injuries.

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“…Sometimes the condition becomes worse leading to increased readmission rates after patient discharge from the hospital as a result of the previously mentioned issue. POI reflectively represents a major source of economic burden with high cost on patient and financial burden on health care facilities [4,5].…”

Section: Introductionmentioning

confidence: 99%

Effect of Sham Feeding on Postoperative Clinical Outcomes among Patients Undergoing Elective Abdominal and Gynecological Surgeries

Riad¹,

Masry²,

Elwan³

et al. 2019

AJNR

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Sham feeding has been demonstrated to be one of the methods to increase bowel motility. Gum chewing, as an alternative to sham feeding, provides the benefits of gastrointestinal stimulation without the complications associated with feeding. Aim: to evaluate the effect of sham feeding on postoperative clinical outcomes among patients undergoing elective abdominal and gynecological surgeries. Subjects: A purposive sample including 150 patients who were admitted to the general surgical and gynecological unit for undergoing elective open abdominal surgeries such as cholecystectomy, appendectomy, hysterectomy, myomectomy. Were divided randomly into two equal groups 75 patients in each Study group (I): practice post-operative sham feeding in addition to the usual routine hospital care such as early mobilization and Control group (II): Follow the usual routine hospital care such as early mobilization only. Setting: The study was conducted at the general surgical and gynecological unit of Menoufia University Hospital. Instruments: Three instruments were utilized, I: A structured Interviewing Questionnaire, II: Postoperative Patient's Outcomes Questionnaire and III: Visual Analogue Scale (VAS). Results: Significant statistical differences existed between both groups regarding the time of resumption of gastrointestinal functions, postoperative ileus symptoms, and incidence of nausea, vomiting, pain and length of hospital stay. Conclusion: Patients who practiced chewing gum as alternative for sham feeding experience earlier return of bowel motility in terms of bowel sounds, first flatus and feeling of hunger than those patients who did not practice chewing gum. Furthermore, there was a significant reduction in pain and length of hospital stay among patients who were practice chewing gum than those who were not. Recommendations: the study recommended that: Sham feeding in a form of gum chewing should be added in the protocol of postoperative nursing care and conducting further studies for evaluating the effect of sham feeding on postoperative ileus among patients undergoing abdominal and gynecological surgeries using a larger sample and different geographical areas.

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Complications of Minimally Invasive Surgery and Their Management

Cited by 20 publications

References 63 publications

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

Laparoscopic Insertion of Various Shaped Trocars in a Porcine Model

How to reduce the risk of organ injuries during surgical instrument insertion in laparoscopic surgery: Pushing/pressing force analysis using forceps with sensors

Effect of Sham Feeding on Postoperative Clinical Outcomes among Patients Undergoing Elective Abdominal and Gynecological Surgeries

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