Ventricular laceration and cardiac tamponade during laparoscopic Nissen fundoplication

Laparoscopic fundoplication is now accepted as an excellent alternative to long term medical therapy for select patients with gastroesophageal reflux disease. Morbidity is uncommon and usually not life threatening. The procedure requires retraction of the left lateral segment of the liver, which has emerged as one of the most troubling technical aspects. This case report represents an uncommon, albeit dramatic, complication involving traumatic injury to the right ventricle thought secondary to trauma from a non-disposable, fan shaped, liver retractor.