[Cavitary viscera injuries during laparoscopy]

Intraoperative incidents of laparoscopic surgery resulting in cavitary viscera injuries are analyzed, based on a series of 6308 patients (6800 operations) operated during a period of 9 years. This retrospective study includes 11 cases: 6 intraoperative cavitary viscera perforations (esophagus, gastric fornix, ileum, sigmoid) have been recognized and solved in the same laparoscopic operation or after conversion. In 5 cases the diagnosis was established in the postoperative period as fistulas (urinary bladder) or diffuse peritonitis caused by various types of injuries (esophagus, small and large bowel) and required reoperations. We present a global view of these cases and also analyze the determinant causes of the complications, emphasize the importance of intraoperative identification of such injuries and specify the place of minimally invasive surgery in the treatment of such accidents with an optimum healing and low rate of postoperative morbidity and mortality.