Overlooked problem of laparoscopic surgery: trocar site bleeding

Abstract

Purpose: Trocar site bleeding is a complication which can be overlooked and prevented if pay attention. It can lead to unwanted problems during surgery if not noticed. In our study, we aimed to investigate the problem that can be seen in every laparoscopic surgery.

Material and Methods: We reviewed the cases who underwent laparoscopic cholecystectomy in our clinic between September 2012-September 2015. Patients with trocar site bleeding after surgery were enrolled into the study. Demographic and postoperative follow-up data of patients were recorded.

Results: Eight of 350 patients (2.3%) with laparoscopic cholecystectomy were taken diagnosis of intra-abdominal hemorrhage after postoperative examinations. Three of the patients were men and five were women, mean age was 45 +/- 15.9 (19-72). Four patients (M/W: 1/3) required reoperation to control bleeding and hematoma drainage. Medical supportive treatment was adequate for the remaining patients. The patients were discharged without any complication.

Conclusion: Trocar site bleeding can be prevented by application of appropriate methods. In particular, special care should be taken when inserting and removing the trocars during the operation. During the entry of secondary trocars it should be accompanied by transillumination and at the end of the operation trocars should be removed from their places under direct vision.