Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy

• Main Authors: Bijan Mohammadhosseini, Shahram Shirani
• Format: Article
• Language: English
• Published: Termedia Publishing House 2011-09-01
• Series: Videosurgery and Other Miniinvasive Techniques
• Subjects: haematoma; laparoscopy; port; abdominal wall; complication
• Online Access: http://www.termedia.pl/Case-report-Intra-abdominal-and-abdominal-wall-haematoma-from-5-mm-port-insertion-site-in-laparoscopic-cholecystectomy,42,17372,1,0.html

Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascularinjury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at thisfirst step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followedlater by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy wasneeded to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocarinsertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertionand entering the abdominal cavity at a right angle may decrease the possibility of this complication.