MAJOR VASCULAR INJURY AND LAPAROSCOPY

Iatrogenic vascular trauma is a hazard that must be considered constan tly during any laparoscopic procedure. We present a case of vessel pen etration presenting as CO2 embolism during insufflation where delayed recognition of the vascular implications of this event led to death fr om exsanguination. The pattern of laparoscopic vascular injuries in Au stralia as reported to the Medical Defence Union (UK) and the New Sout h Wales Medical Defence Union is reviewed and compared with previously reported cases of vascular trauma in laparoscopy. Recommendations are made for the diagnosis and most importantly for the prevention of CO2 embolism and major vascular injury at laparoscopy.