Vascular injury is one of the major complications of laparoscopic surg
ery. Prompt diagnosis is crucial for proper management of this potenti
ally Life-threatening complication. Two cases of iliac artery puncture
occurred during operative laparoscopy. The injuries were not diagnose
d immediately, probably due to the initial accumulation of blood in th
e retroperitoneum. Significant damage to large blood vessels may not b
e readily apparent during laparoscopic surgery.