[Bowel injuries after port insertion in laparoscopy. Gynerisq's database analysis]

Area of Science:

• Minimally Invasive Surgery
• Surgical Safety
• Gynecologic Surgery

Background:

• Port insertion during laparoscopy presents significant risks.
• The French College of Gynecologists and Obstetricians (CNGOF) issued recommendations in 2010 to mitigate these risks.
• Analysis of incident circumstances and consequences is essential to evaluate adherence to these guidelines.

Purpose of the Study:

• To analyze the circumstances and consequences of bowel injuries during laparoscopic port insertion.
• To determine if incidents were preventable by adhering to established recommendations.

Main Methods:

• Analysis of 114 incidents reported to Gynerisq, an approved risk management organization.
• Focus on 31 reported cases of bowel injuries during port insertion.
• Evaluation of surgical context, patient history, and adherence to recommendations.

Main Results:

• 31 bowel injuries were reported, with 77.4% occurring during planned interventions.
• 32.3% of interventions were deemed complex, and 54.8% of patients had a history of laparotomy.
• 17 of 27 injuries during Veress needle or open laparoscopy were deemed avoidable; 10 incidents occurred due to non-adherence to recommendations.

Conclusions:

• Bowel injuries during port insertion are not limited to emergency or complex cases.
• Patient risk factors, such as prior laparotomy, are significant.
• Adherence to CNGOF recommendations may reduce the incidence of these preventable injuries.