Avoiding major vessel injury during laparoscopic instrument insertion

Major vessel injuries during laparoscopy most commonly occur during insertion of Veress needle and port trocars through the abdominal wall. This article reviews methods for avoiding major vessel injury while gaining laparoscopic access, including anatomic relationships of abdominal wall landmarks to...

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Bibliographic Details
Published inObstetrics and gynecology clinics of North America Vol. 37; no. 3; p. 387
Main Authors Pickett, Stephanie D, Rodewald, Katherine J, Billow, Megan R, Giannios, Nichole M, Hurd, William W
Format Journal Article
LanguageEnglish
Published United States 01.09.2010
Subjects
Aorta, Thoracic - injuries
Blood Vessels - injuries
Female
Gynecologic Surgical Procedures - adverse effects
Humans
Iliac Artery - injuries
Iliac Vein - injuries
Intraoperative Complications - epidemiology
Intraoperative Complications - prevention & control
Laparoscopy - adverse effects
Laparoscopy - methods
Needles
Obesity
Overweight
Surgical Instruments
Venae Cavae - injuries
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Summary:Major vessel injuries during laparoscopy most commonly occur during insertion of Veress needle and port trocars through the abdominal wall. This article reviews methods for avoiding major vessel injury while gaining laparoscopic access, including anatomic relationships of abdominal wall landmarks to the major retroperitoneal vessels. Methods for periumbilical placement of the Veress needle and primary trocar are reviewed in terms of direction and angle of insertion, and alternative methods and locations are discussed. Methods for secondary port placement are reviewed in terms of direction, depth, and speed of placement.
ISSN:1558-0474
DOI:10.1016/j.ogc.2010.05.002