Exxcellence pearls: complications of gynecologic laparoscopy

Question 0

What are risk factors for complications of laparoscopy in gynecologic cases?

Answer 0

Prior abdominal surgery, endometriosis, pelvic infection, bowel distention, large pelvic masses, adhesions, cardiopulmonary disease, diaphragmatic hernias, pregnancy

Question 1

What is the reported incidence of vascular injury at laparoscopy?

Answer 1

0.1-6.4 per thousand

Question 2

What vessels are injured typically in gynecologic surgeries?

Answer 2

Abdominal wall vessels such as the inferior epigastrics, omental vessels, mesenteric vessels, middle sacral artery, iliac artery and vein, vena cava and aorta

Question 3

What signs during surgery suggest a bladder injury?

How can this be confirmed?

Answer 3

Gas or blood in the Foley bag.

Retrograde filling of the bladder with dye.

Question 4

How should thermal injuries of the bladder be managed?

Answer 4

Resection and reimplantation if necessary

Question 6

What is the incidence of trocar site bowel herniation?

Answer 6

0.02%