VASCULAR COMPLICATIONS IN MINIMALLY INVASIVE SURGERY

Injuries to major vessels in the course of laparoscopic surgery are ra re but serious, life-threatening complications. We report nine iatroge nic vascular injuries during minimally invasive surgery that occurred between January 1991 and December 1995 in surgical and obstetric-gynec ologic services in the Austrian province of Styria. The total vascular complication rate is 0.08%. As these data show, the distal abdominal aorta and vena cava, as well as the large pelvic vessels, are especial ly susceptible to injury when the Veress needle and trocars are insert ed into the abdomen. Surgical reconstruction of these eight arterial l esions required a polytetrafluorethylene (PTFE) patch in one case, and the resection of the damaged section of the artery and reanastomosis in two others. The remaining lesions, as well as an isolated vein inju ry, were corrected with direct suturing of the vessel. Pelvic circulat ion was completely restored in all patients, and permanent damage was avoided.