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Re: Trauma of vessels during laporoscopyFrom: andrelat@vega.ivic.qc.caMon Dec 28 15:46:03 1998
At 13:45 98-12-28 -0600, you wrote: >Thomas Ind wrote: >> >> Please refer to my post "Hasson versus Verres insufflation" I regret >> that my server is going so slowly tonight that I don't want to go back >> to it but I had the data infront of me at the time. >> >> If I recall the risk was 5-10/10,000 with an 8% mortality with a Verres >> approach. No reported cases with the Hasson approach >> >> -- >> Dr Thomas Ind MB BS MD MRCOG >> St George Hospital >> Kogarah >> Sydney >> NSW 2217 >> AUSTRALIA I agree with the first paper that preference should be given to the method with which the surgeon is most comfortable or with which he or she has the most experience. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ TITLE: The safety of laparoscopy performed by direct trocar insertion and carbon dioxide insufflation under vision. AUTHORS: Woolcott R SOURCE: Aust N Z J Obstet Gynaecol 1997 May;37(2):216-9 Review of the published literature demonstrated bowel or vessel perforation rates (requiring laparotomy or resuscitation) of 1 in 1,000 regardless of whether the method of gaining peritoneal access was open (Hasson) technique, Verres needle insufflation, or direct trocar. It is simply wrong to deduce from the available data that one particular technique of gaining peritoneal access is superior to another. Each have their individual advantages and disadvantages and similar morbidity when performed by experienced operators with appropriate indications. In light of this observation, each alternative should be considered by the individual surgeon to assess which would best suit his or her operating technique and the particular circumstance of each patient. Indeed preference should be given to the method with which the surgeon is most comfortable or with which he or she has the most experience. TITLE: Minilaparotomy for laparoscopy: not a foolproof procedure. AUTHORS: Kornfield EA; Sant GR; O'Leary MP SOURCE: J Endourol 1994 Oct;8(5):353-5 We report a case of a 23-year-old man whose small bowel was injured during placement of a Hasson trocar at the time of laparoscopic varix ligation. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dr Paul-André Latulippe MD FRCCP(s) Ob/Gyn 111 Rang 9 St-Christophe d'Arthabaska Québec,Canada G6P 6S1 tel:(819) 357-1784
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