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Aortic injury during laparoscopic fundoplication: an underreported complication
P L Leggett1, C D Bissell, R Churchman-Winn
1The University of Texas-Houston Health Science Center, 800 Peakwood, Suite 8B, Houston, TX 77090, USA. drleggett@drleggett.com
Surgical Endoscopy
|April 23, 2002
Summary
A rare aortic injury during laparoscopic fundoplication, a minimally invasive surgery for GERD, led to fatal bleeding. This case highlights a previously unreported complication, emphasizing the risks of advanced surgical techniques.
Area of Science:
- Minimally invasive surgery
- Gastroenterology
- Surgical complications
Background:
- Laparoscopic surgery is increasingly used for gastroesophageal reflux disease (GERD) due to patient benefits like reduced pain and faster recovery.
- This case report details a rare complication of laparoscopic fundoplication.
- A review of literature on complications of minimally invasive fundoplication is included.
Observation:
- A 52-year-old female with GERD and esophageal motility disorder underwent laparoscopic Toupet fundoplication.
- A needle injury to the aorta occurred during the procedure.
- The bleeding source was not identified during the surgery (converted to laparotomy) or two subsequent operations.
Findings:
- The patient died from blood loss, with the aortic injury discovered postmortem.
- This represents a previously unreported complication of laparoscopic fundoplication, distinct from trocar-related injuries.
- Other surgeons have indicated this complication has occurred previously.
Implications:
- Laparoscopic fundoplication, while beneficial, carries risks including rare but severe complications like aortic injury.
- Awareness of this potential complication is crucial for surgeons performing minimally invasive fundoplication.
- Further research and vigilance are needed to prevent and manage such severe intraoperative injuries.