Iliac vascular injuries during elective laparoscopic surgery

Although it is extremely uncommon, iliac vascular injury is a serious compl ication of laparoscopic surgery. We performed a retrospective review of fiv e patients who sustained injury to the iliac vessels during elective laparo scopic surgery. We reviewed the mechanism and location of injury for each c ase and examined ways in which such complications can be prevented, There w ere four women and one man; their mean age was 32 years. Three patients wer e undergoing laparoscopy at our institution, and two patients were transfer red from outlying facilities soon after the injuries occurred. There were a total of seven iliac vascular injuries among our five patients. Three case s involved injury caused by the insufflation needle; the other two were inj ured by trocar introduction. Postoperative sequelae included decreased lowe r-extremity pulses in two patients and lower-extremity edema in three patie nts. The incidence of iliac vascular injury can be significantly reduced by proper insertion technique, the use of an open (Hasson) approach rather th an the percutaneous insufflation needle, and a thorough knowledge of the va scular anatomy in the pelvic region.