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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Vascular Surgery

Background:

  • Vascular injury is a known risk during laparoscopic surgery, particularly during pneumoperitoneum.
  • Large abdominal vessel injury can occur, necessitating careful surgical technique.

Observation:

  • Two cases of vascular injury during laparoscopic urologic surgery are presented.
  • Case 1: Inferior vena cava (IVC) hematoma during laparoscopic partial nephrectomy.
  • Case 2: IVC perforation during laparoscopic live donor nephrectomy.

Findings:

  • Both patients experienced significant bleeding requiring suture repair.
  • Estimated blood loss was 300ml in the nephrectomy case and 200ml in the donor nephrectomy case.
  • Neither patient had prior abdominal surgery.

Implications:

  • Urologists must be aware of this uncommon but potentially lethal complication.
  • Laparoscopic repair is possible for experienced surgeons; conversion to open surgery is recommended when in doubt.
  • Prompt recognition and management are crucial to minimize morbidity and mortality.