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KMID : 0358420070500020243
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Korean Journal of Obstetrics and Gynecology
2007 Volume.50 No. 2 p.243 ~ p.254
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Prevention and management of complication of pelviscopic operation
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Ku Seung-Yup
Kim Jung-Gu
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Abstract
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Since the introduction of laparoscopic surgery in 1950’s, pelviscopic surgery has been established as a popularly used surgical modality in many areas due to the wide spread of minimally invasive surgery in 1980’s. In spite of its many advantages compared to laparotomy, pelviscopic surgery is accompanied by many complications caused by equipments or anesthesia as various methods have been developed. Common complications include the injury of major and abdominal wall vessels, intestines, bladder and ureter, incisional hernia, heat injury by electricity, gas embolism, shoulder pain, pneumothorax, subcutaneous emphysema, and venous thrombosis. The frequency of complications is known to be 0.2-10.3%, and the half happens during the process of gas insufflation needle or trocar insertion. Order to prevent the complications, the operators should observe the safety regulations and perform the surgical procedures according the detailed operation principles. The patients with contraindications such as intestinal obstruction, hernia, severe cardiovascular diseases or peritonitis and extreme ages, should be avoided. The operators should be prepared for the expected complications by preoperatively evaluating the risk factors such as history of abdominal surgery, obesity, and heart and lung diseases. In addition, they should be well aware of biophysics of instruments, be experienced, and follow the basic safety rules such as the precautions about unnoticeable electrical damage of neighboring tissues.
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KEYWORD
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Pelviscopy, Complications, Prevention
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