Siufi Neto Joao, Santos Siufi Daniela Freitas, Magrina Javier F
Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA; Surgical Oncologist, Sírio - Libanês Hospital, São Paulo, SP 01308-050, Brazil.
Department of Gynecologic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA; Surgical Oncologist, Sírio - Libanês Hospital, São Paulo, SP 01308-050, Brazil.
Best Pract Res Clin Obstet Gynaecol. 2016 Aug;35:13-9. doi: 10.1016/j.bpobgyn.2015.11.005. Epub 2015 Dec 1.
All laparoscopic procedures, laparoscopic or robotic-assisted, start with a trocar entry. Unfortunately unknown to most, this is an extremely important part of the surgery, as 80% of major vascular injuries and 50% of intestinal injuries occur during this procedure. Laparoscopic first entry is often delegated to trainees with little experience, wrongly assuming that laparoscopic entry is similar to incisional entry at laparotomy. This may result in patient death (mortality of major vascular injuries is 11% and unrecognized intestinal injuries is 5%) or significant temporary or permanent morbidity.
所有腹腔镜手术，无论是传统腹腔镜还是机器人辅助腹腔镜手术，都始于套管针穿刺进入。遗憾的是，大多数人并不了解，这是手术中极其重要的一部分，因为80%的主要血管损伤和50%的肠道损伤都发生在这个过程中。腹腔镜首次穿刺进入常常被交给经验不足的实习生，错误地认为腹腔镜穿刺进入与开腹手术的切口进入相似。这可能导致患者死亡（主要血管损伤的死亡率为11%，未被识别的肠道损伤的死亡率为5%）或严重的暂时或永久性发病。
