Non-trocar related major retroperitoneal bleeding during laparoscopic appendectomy

Area of Science:

• Minimally-invasive surgery
• Surgical complications
• Vascular injury

Background:

• Vascular injuries are known complications of laparoscopic appendectomy, often linked to trocar or Veress needle insertion.
• The evolution of laparoscopy necessitates reporting rare iatrogenic injuries to enhance surgical safety.
• Awareness and proper management guidelines are crucial for unexpected complications in minimally-invasive procedures.

Purpose of the Study:

• To report a rare case of non-trocar related retroperitoneal vascular injury during laparoscopic appendectomy.
• To highlight the importance of vigilance for unusual complications in routine laparoscopic procedures.
• To contribute to the literature on iatrogenic injuries in minimally-invasive surgery.

Main Methods:

• Case report of a patient undergoing laparoscopic appendectomy.
• Detailed description of the surgical procedure and the unexpected vascular complication.
• Review of relevant literature on vascular injuries in laparoscopic surgery.

Main Results:

• A major retroperitoneal vascular injury occurred during a routine laparoscopic appendectomy.
• The injury was not associated with trocar or Veress needle insertion, representing an unusual mechanism.
• The patient's management and outcome were documented.

Conclusions:

• Non-trocar related vascular injuries can occur during laparoscopic appendectomy, albeit rarely.
• Surgeons must maintain a high index of suspicion for unexpected iatrogenic injuries during minimally-invasive procedures.
• Reporting such unusual cases is vital for improving surgical education and patient safety.