Management of hemorrhage during laparoscopy

Bleeding can be a complication of laparoscopic procedures commonly performe d by urologists, such as pelvic node dissection and nephrectomy, and is oft en difficult to manage. Hemorrhage also can occur asa result of Veress need le or trocar placement, and there are specific strategies for the managemen t of these injuries. Laparoscopic clip appliers, laparoscopic staplers, lap aroscopic suturing, various energy sources (monopolar and bipolar electroca utery, laser, ultrasonic dissectors, and argon beam coagulators), and topic al agents (gelatin foam, cellulose, collagen, and fibrin sealant) can be us ed to obtain hemostasis, Converting to laparotomy to obtain hemostasis may be necessary in some cases, Proper patient selection is important for lower ing the risk of hemorrhage.