This study is a review of conditions and circumstances associated with 15 i
njuries to great vessels during laparoscopic surgery, Thirteen cases were l
itigated in Canada and two occurred in the author's operating room. Body ha
bitus may have been an underlying factor in the injuries. Most injuries wer
e entry related and independent on complexity of surgery. One was caused by
the Veress needle and one by a secondary trocar, and three occurred during
dissection of adhesions. Ten were primary trocar injuries, 9 after pneumop
eritoneum and I at direct trocar insertion. Of these, five were caused by r
eusable and five by disposable trocars with so-called safety shields. In 6
of 15 cases recognition of the injury was delayed; 5 in the recovery room.
Eleven women had uncomplicated recovery. Of 13 litigated cases, 8 (62%) res
ulted in settlement.