Prevention and management of unexpected injuries out of the visual field during laparoscopic surgery
10.3781/j.issn.1000-7431.2023.2304-0166
- VernacularTitle:警惕腹腔镜手术视野外的意外损伤及其预防和处理
- Author:
Peng LIU
1
;
Zheng LOU
;
Wei ZHANG
Author Information
1. 海军军医大学第一附属医院肛肠外科,上海 200433
- Keywords:
Colorectal surgery;
Laparoscopic surgery;
Unexpected injuries out of the visual field;
Management;
Prevention
- From:
Tumor
2023;43(5):376-381
- CountryChina
- Language:Chinese
-
Abstract:
The application of laparoscopy in general surgery,especially in colorectal surgery,has been a routine clinical practice.Its safety and efficacy have been widely recognized.Different from open abdominal surgery,laparoscopic surgery has its unique characteristics.In clinical practice,other organs out of visual field are often injured during operation,including both empty organs such as stomach,duodenum,small intestine and colon,as well as parenchymal organs such as spleen.If it is found during the operation,corresponding remedial measures can be taken in time.If it occurs after the operation,it is difficult to be distinguished from other complications such as anastomotic leakage,and treatment is quite challenging,seriously affecting the medical safety of patients,and even leading to doctor-patient disputes.Based on the author's experience,unexpected injuries may occur starting from the second of Trocar insertion,most of which occurred during intraoperative traction and detachment,or during the entry and exit of instruments into Trocar.The occurrence of accidental injury is often subtle,but through gentle and careful operation,attention to the occurrence of unexpected events during the surgery,and comprehensive observation of the abdominal cavity before the end of the surgery,it can be effectively avoided in a timely manner.A stable surgical team can greatly reduce the unexpected damage out of the field by reducing the grasping of irrelevant tissues and keeping the instruments away from the camera.Only with the instrument in the hand and the awe in the heart can we really avoid unnecessary damage.This article intends to discuss the author's experience in preventing and treating accidental injury in the field of laparoscopic vision in clinical practice,in order to provide references for colorectal surgeons.
