Large bowel injuries during gynecological laparoscopy

作     者：Kahraman ülker Turgut Anuk Murat Bozkurt Yetkin Karasu 

作者机构：Department of Obstetrics and Gynecology Kafkas University School of Medicine 36000 Kars Turkey Department of General Surgery Kafkas University School of Medicine 36000 Kars Turkey 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2014年第2卷第12期

页      面：846-851页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Colon Gynecology Intraoperative complications Laparoscopy Wounds and injuries 

摘      要：Laparoscopy is one of the most frequently preferred surgical options in gynecological surgery and has advantages over laparotomy, including smaller surgical scars, faster recovery, less pain and earlier return of bowel functions. Generally, it is also accepted as safe and effective and patients tolerate it well. However, it is still an intra-abdominal procedure and has the similar potential risks of laparotomy, including injury of a vital structure, bleeding and infection. Besides the wellknown risks of open surgery, laparoscopy also has its own unique risks related to abdominal access methods,pneumoperitoneum created to provide adequate operative space and the energy modalities used during the procedures. Bowel, bladder or major blood vessel injuries and passage of gas into the intravascular space may result from laparoscopic surgical technique. In addition, the risks of aspiration, respiratory dysfunction and cardiovascular dysfunction increase during laparoscopy. Large bowel injuries during laparoscopy are serious complications because 50% of bowel injuries and60% of visceral injuries are undiagnosed at the time of primary surgery. A missed or delayed diagnosis increases the risk of bowel perforation and consequently sepsis and even death. In this paper, we aim to focus on large bowel injuries that happen during gynecological laparoscopy and review their diagnostic and management options.