Techniques for laparoscopic repair of major intra-operative vascular injury

Mehraneh D Jafari, MD, Alessio Pigazzi, MD, PhD

University of California, Irvine

A 39-year-old male with a history of HIV presented with 2-week history of obstipation. A colonoscopy was consistent with benign sigmoid stricture for which he was taken to the operating room for a laparoscopic exploration and possible sigmoidectomy. Intra-operative findings were consistent with a sigmoid volvulus. A sigmoid colectomy was performed in a standard medial to lateral fashion. A thermal injury to the left external iliac vein occurred during dissection of the peritoneum over the left pelvic brim. Direct pressure was placed on bleeding vessel via Ray-Tec. The colon was mobilized, allowing for better visualization of the injury and the vessel. Once visualization was obtained, a 4 mm venous laceration was noted. Hemostasis was achieved via application of pressure followed by intracorporeal 4-0 vicryl sutures. The patient remained hemodynamically stable during the entire case with an EBL of 250cc. Post-operatively the patient did well and was discharged home on POD 3 and is doing well at his 6month post-op visit.

Session: Podium Presentation

Program Number: V026

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