Laparoscopic Surgical Injury

 

Surgery performed in a laparoscopic manner has become the standard for many thoracic and abdominal medical procedures because it is considered minimally invasive. Keeping incisions small means healing after the procedure can be accomplished in less time, and also makes for less surface area that potentially harmful bacterial infections can invade. The average size of the incisions ranges from 0.5 to 1.5 cm. There are typically a couple of incisons made. One or several incisions are for the insertion of instruments needed for the actual procedure. Another incision is made for the trocar. This instrument is necessary for insufflation, or a ballooning of the area around where the surgery is to take place. Without the large opening provided by a traditional surgery, room to maneuver has to be made. Other instruments that are inserted through trocars are a light and camera for visualization of the surgical area. 

Surgeries where laparascopic techniques can be used are:

  • Anti-reflux procedures
  • Appendectomy
  • Bariatric procedures (i.e., lap band, gastric by-pass)
  • Bowel  incontinence
  • Colon polyps
  • Colorectal cancer
  • Crohn’s disease
  • Diverticulitis
  • Endometriosis
  • Gall Bladder
  • Hernia
  • Many types of biopsies and examinations
  • Nephrectomy
  • Prostate
  • Rectal prolapse
  • Tubal ligation
  • Ulcerative colitis

Disadvantages associated with laparoscopic surgery are all physician directed. Surgeons performing laparoscopic procedures must be highly skilled and competent because they are working in less space than a physician performing an open surgery. This requires more practice and dexterity than a typical surgeon. The surgical field is visualized on a monitor screen, which means the surgeon does not have the depth perception that is available in an open surgery.  Also, the use of tools in the body instead of hands provides no tactile feedback to the surgeon.  Like depth perception, pressure perception is also a tricky negotiation.

Potential complications to laparoscopic surgery fall into several categories; complications of access, complications of pneumoperitoneum (insufflation), and complications of the operative procedure itself.

Complications of access is the category where things are likely to go wrong. 57% of complications in laparoscopic surgery fall into the area of access. The following is a list of complications of access:

  • Retroperitoneal vessel damage
  • Hemorrhage
  • Bowel perforation
  • Peritonitis
  • Site infection
  • Herniation
  • Abdominal wall hematoma
  • Need to go with open surgery 
  • Fascial dehiscence (improper healing of the connective tissue after surgery)
  • Death

Complications of pneumoperitoneum (insufflation):

  • Hypothermia
  • Deep vein thrombosis development
  • Respiratory acidosis
  • Increased blood pressure during surgery
  • Decreased cardiac output
  • Need to go to open surgery if insufflation cannot be done

Complications of the operative procedure:

  • Infection
  • Hemorrhage
  • Burns form poorly monitored electrodes
  • Death

While laparoscopic surgery is considered a good option over traditional open surgery, there are still complications that can occur. There must be considerable skills utilized by the performing surgeon. Incompetence or a lack of experience on the part of the surgeon can result in injuries or death. If you a loved one suffered injuries or death due to the negligence of a surgeon or a surgical team member, you may be eligible for damages. Call the Sweeney Law Firm and let our experts review the facts to see if you have a surgical error medical malpractice case. If we accept your case, there is no cost for representation.  We work on a contingency fee basis, meaning we don’t get paid unless there is a settlement or recovery of funds for you.

 

Related article on this site: Megacolon.