Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy

Abstract

Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascular injury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at this first step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followed later by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy was needed to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocar insertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertion and entering the abdominal cavity at a right angle may decrease the possibility of this complication.

Prospective Assessment of Trocar‐Specific Morbidity in Laparoscopy

“…The cosmetic result from a patient’s point of view, using various questionnaires and photos, after multiport laparoscopy vs SPL has been assessed by some authors but surprisingly not with validated scales or scores [12–19]. To our knowledge, our study is the first to analyze, from a patient’s point of view, the cosmetic results with a validated score originally developed to assess patient satisfaction with the scar in plastic surgery [14].…”

Abdominal Wall Vascular Injury by Drain Insertion after Anterior Lumbar Spinal Fusion

“…Based on our literature review, there is no previous report of injury to the abdominal wall artery by drain insertion, although arterial injury of the laparoscopic portal sites has been reported. 9 The surgeon did not notice active bleeding in the abdominal wall while inserting the drain before closing the wound. It may be because the size of the artery that was injured was small, bleeding was not too alarming, and significant haematoma took time to develop.…”

Complications of laparoscopic cholecystectomy

“…Кровотечение из области прокола троака-ром брюшной стенки является довольно ред-ким осложнением, и как отмечают ряд авторов может быть не распознано во время операции, так B. Mohammadhosseini и S. Shirani описали формирование обширной гематомы брюшной стенки после ЛХЭ, что потребовало выполнения лапаротомии через несколько суток [30]. По мнению большинства хирургов, столкнувшихся с таким осложнением, основной причиной его развития является проведение троакара в об-ласти нижней эпигастральной артерии.…”