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Common iliac artery injury during the abdominal entry phase of gynecologic laparoscopy: a case report
Sandro Rullo1, Carlo Ticconi, Andrea Ascoli Marchetti
1Section of Gynecology and Obstetrics, Department of Surgery, Azienda Ospedaliera Universitaria "Policlinico Tor Vergata, Rome, Italy. sandro.rullo@tin.it
Background:
Although not frequent, major vascular injury (MVI) during laparoscopy in gynecologic surgery can cause a sharp increase in morbidity and mortality.
Case:
During the abdominal entry stage of operative laparoscopy, perforation of the left common iliac artery occurred. Prolonged hiccups might have played a role.
Conclusion:
Entry into the abdominal cavity during laparoscopy should be performed with the safer, controlled technique. In spite of the fact that no surgical procedure or de- * vice is absolutely foolproof, the laparoscopic abdominal approach should be performed with the technique that maximally reduces the likelihood of MVI. Once a major vascular injury is recognized or suspected, immediate conversion to laparotomy should be considered.
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