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Assessment of laparoscopic injuries by three methods
P K Tulikangas1, S Beesley, N Boparai
1Minimally Invasive Surgery Center, The Cleveland Clinic Foundation, Ohio 44195, USA. tulikap@ccf.org
Objective:
To compare laparoscopic, gross, and fluorescent assessment of laparoscopic pelvic injuries.
Design:
Experimental prospective study.
Setting:
Cleveland Clinic Foundation Animal Research Laboratory, Cleveland, Ohio.
Animal(S):
Nonpregnant adult female pigs.
Intervention(S):
Pelvic organs injured with laparoscopic energy sources were assessed laparoscopically, grossly, and with a fluorescent indicator and Wood's lamp.
Main Outcome Measure(S):
Three different measurements of each laparoscopic injury.
Result(S):
Assessment of injuries by laparoscopy did not differ significantly from gross assessment of injuries. In the segments of bowel and bladder that were injured with monopolar cautery, the Wood's lamp assessment of the injuries was significantly longer than the laparoscopic assessment of the injuries.
Conclusion(S):
Laparoscopic assessment of injured ureters, bowel, and bladder appear to be similar to gross assessment of these tissues. In tissue where the serosal surface is intact, the use of a fluorescent dye and a Wood's lamp provides a clear margin of the injured tissue.