Chen Pei-Chen, Li Pei-Chen, Chen Hsuan, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan.
Gynecol Minim Invasive Ther. 2022 May 4;11(2):121-123. doi: 10.4103/gmit.gmit_53_21. eCollection 2022 Apr-Jun.
Complications related to open entry for laparoscopic procedures are relatively rare, and the incidence of closed entry-related complications is 0.4 per 1000 cases. We report a case of serosal injury to a distended stomach that was caused during open entry. A 37-year-old woman presented with a 1-year history of dysmenorrhea. Transvaginal ultrasonography revealed a uterine myoma and cesarean section (C/S) wound defect. Laparoscopic single-site myomectomy and repair of the C/S wound defect were planned. Open abdominal entry was achieved at the umbilicus, and the patient's stomach was distended and injured by the electric knife (30 watts). After identifying the injury, we inserted a nasogastric tube to deflate the stomach and repaired the gastric serosal injury. The laparoscopic myomectomy and C/S defect repair were subsequently performed without complications. The patient has remained free from complications during the 1-year follow-up. Gastric serosal injury during open entry is a rare complication. Insertion of a nasopharyngeal tube and routine percussion of the abdomen before entering the abdominal cavity are the most important steps to prevent this complication.
腹腔镜手术开放入路相关并发症相对少见，闭合入路相关并发症的发生率为每1000例中有0.4例。我们报告一例在开放入路过程中导致扩张胃浆膜损伤的病例。一名37岁女性有1年痛经病史。经阴道超声检查发现子宫肌瘤和剖宫产（C/S）伤口缺损。计划行腹腔镜单部位子宫肌瘤切除术及C/S伤口缺损修复术。在脐部进行开放腹部入路时，患者的胃因电刀（30瓦）而扩张并受伤。在识别损伤后，我们插入鼻胃管使胃减压，并修复胃浆膜损伤。随后进行腹腔镜子宫肌瘤切除术和C/S缺损修复术，未出现并发症。在1年的随访期间，患者未出现并发症。开放入路时胃浆膜损伤是一种罕见的并发症。插入鼻咽管和在进入腹腔前常规叩诊腹部是预防该并发症的最重要步骤。
