Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

Polychronidis, Alexandros; Tsaroucha, AK; Karayiannakis, Anastasios J.; Perente, Sebachedin; Efstathiou, Eleftheria; Simopoulos, C.

doi:10.1177/147323000503300312

Cited by 18 publications

(17 citation statements)

References 12 publications

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“…Furthermore, the specimens were resected within a few hours after ablation. These thermal effects may have continued to propagate after the acute insult [16], which could suggest that we may have underestimated the actual amount of injury incurred. Waiting a few days to resect the treated tissue, however, was not acceptable given the stage of this study.…”

Section: Discussionmentioning

confidence: 99%

A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial

et al. 2010

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Endoscopic RFA is capable of delivering therapy to the distal colon. Injury is limited to the muscularis propria or less depth when no more than two ablations are applied regardless of the energy density used. Based on these feasibility and dosimetry results, the authors will continue investigation using these and smaller energy doses to initiate trials ultimately with patients who have suitable mucosal and submucosal disorders of the lower gastrointestinal tract including chronic, nonulcerated hemorrhagic radiation proctitis and angiodyplasia.

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Section: Discussionmentioning

confidence: 99%

A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial

et al. 2010

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“…Monopolar electrosurgery is shown to have higher and larger temperature and thermal spread [17]. The monopolar electrosurgery has also lead to post operative complications even in common procedure like laparoscopic cholecystectomy [18], [19]. The use of monopolar electrosurgery has even lead to death [4], [5].…”

Section: Discussionmentioning

confidence: 99%

Face validation of the Virtual Electrosurgery Skill Trainer (VEST©)

Sankaranarayanan

Miller

et al. 2015

Surg Endosc

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Background Electrosurgery is a modality that is widely used in surgery, whose use has resulted in injuries, OR fires and even death. The SAGES has established the FUSE program to address the knowledge gap in the proper and safe usage of electrosurgical devices. Complementing it, we have developed the Virtual Electrosurgery Skill Trainer (VEST©), which is designed to train subjects in both cognitive and motor skills necessary to safely operate electrosurgical devices. The objective of this study is to asses the face validity of the VEST© simulator. Methods Sixty-three subjects were recruited at the 2014 SAGES Learning Center. They all completed the monopolar electrosurgery module on the VEST© simulator. At the end of the study, subjects assessed the face validity with questions that were scored on a 5-point Likert scale. Results The subjects were divided into two groups; FUSE experience (n = 15) and no FUSE experience (n = 48). The median score for both the groups was 4 or higher on all questions and 5 on questions on effectiveness of VEST© in aiding learning electrosurgery fundamentals. Questions on using the simulator in their own skills lab and recommending it to their peers also scored at 5. Mann-Whitney U test showed no significant difference (p > 0.05) indicating a general agreement. 46 % of the respondents preferred VEST compared to 52 % who preferred animal model and 2 % preferred both for training in electrosurgery. Conclusion This study demonstrated the face validity of the VEST © simulator. High scores showed that the simulator was visually realistic and reproduced lifelike tissue effects and the features were adequate enough to provide high realism. The self-learning instructional material was also found to be very useful in learning the fundamentals of electrosurgery. Adding more modules would increase the applicability of the VEST© simulator.

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“…Though rare, laparoscopic cholecystectomy is associated with electrothermal injury to the bowel, which may occur within or outside the laparoscopic field [ 1 ]. Such injuries can lead to fatal outcomes if a prompt diagnosis is not made at the time of presentation [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Delayed jejunal perforation after laparoscopic cholecystectomy

Browne

Dixon

2016

J. surg. case rep.

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Bowel perforation is a rare complication of laparoscopic cholecystectomy, which if left undiagnosed can have fatal consequences. In addition, isolated small bowel perforation is extremely rare and should be considered in patients presenting with sudden onset abdominal pain in the postoperative period. A 57-year-old male with symptomatic gallstones underwent urgent laparoscopic cholecystectomy and was discharged home on postoperative day (POD) 1 without complications. He presented to the emergency department on POD 11 complaining of sudden onset abdominal pain. A CT scan did not confirm a diagnosis and he was admitted for observation. On post admission day 2, he became significantly peritonitic and laparotomy revealed jejunal perforation. Bowel resection with hand-sewn anastomosis was completed and he was discharged on POD 10. Follow-up at 6 weeks revealed no further issues. We review the literature on small bowel perforation post laparoscopic cholecystectomy.

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Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

Cited by 18 publications

References 12 publications

A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial

A feasibility and dosimetric evaluation of endoscopic radiofrequency ablation for human colonic and rectal epithelium in a treat and resect trial

Face validation of the Virtual Electrosurgery Skill Trainer (VEST©)

Delayed jejunal perforation after laparoscopic cholecystectomy

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