Filter by keywords:



Filtering documents. Please wait...

1/7. Management of a broken needle at the time of laparoscopic burch.

    Loss of surgical instrumentation in endoscopic procedures poses problems not faced in traditional surgery. We describe the breakage and subsequent recovery of a 2-mm segment of needle from an Autosuture Endostitch device (U.S. Surgical) during a laparoscopic Burch urethropexy.
- - - - - - - - - -
ranking = 1
keywords = breakage
(Clic here for more details about this article)

2/7. Intraoperative breakage of a 25-gauge vitreous cutter.

    PURPOSE: To report breakage of a 25-gauge vitreous cutter during vitreous surgery. DESIGN: Interventional case report. methods: A 60-year-old woman was referred for management of an epiretinal membrane at the macula. visual acuity was 20/100 in the affected left eye. Vitreous surgery using a 25-gauge vitrectomy system was carried out with a combination of conventional cataract surgery. RESULTS: The vitreous cutter was lodged within the sclerotomy cannula after peripheral vitrectomy and was pulled together with the cannula. The cannula was reinserted by trocar, but as the floating peeled epiretinal membrane was dissected with the vitreous cutter, the tip of the cutter was broken and was aspirated with the membrane. Stereoscopic microscopy and scanning electron microscopy demonstrated that the edge that had broken at the cutter port was smooth. CONCLUSION: Although 25-gauge instruments remain useful, care should be taken against rare surgical complications related to their fragility.
- - - - - - - - - -
ranking = 5
keywords = breakage
(Clic here for more details about this article)

3/7. Suture passer tip breakage during laparoscopic ventral hernia repair.

    Laparoscopic ventral hernia repair generally employs a tacker and a suture passer to secure the mesh to the abdominal wall. We reviewed cases of Gore Suture Passer tip breakage during these procedures and their management. Surgeons performing laparoscopic ventral hernia repair were asked about encountered complications relating to the Gore Suture Passer instrument. charts of the patients with significant alteration in the course of their procedure secondary to such complication were reviewed. Two cases of suture passer tip breakage were identified. One required fluoroscopy to localize and recover the tip, resulting in significant prolongation of the operation. The other required conversion to laparotomy with mesh removal; the tip of the Gore Suture Passer was found in the pelvis and the hernia was repaired with a Stoppa technique. The Gore Suture Passer tip may break during laparoscopic ventral hernia repair, which may significantly complicate the case.
- - - - - - - - - -
ranking = 6
keywords = breakage
(Clic here for more details about this article)

4/7. Intraoperative breakage of 20-gauge Tano forceps.

    PURPOSE: To report three cases with breakage of a 20-gauge kryptonite forceps during vitreoretinal surgery. DESIGN: Interventional case report. methods: Pars plana vitrectomy that included a membrane peeling was performed in three patients through standard ports with 20-gauge vitrectomy systems. The peeling procedure was attempted with the end-gripping kryptonite forceps. RESULTS: Intraoperatively, the branch/tip broke and dropped onto the posterior pole. Removal of the broken part was uncomplicated, and the subsequent clinical course was unremarkable. In one case, the handle and branch/tip part were exchanged inadvertently. In the other two cases, neither an exchange nor a maladaptation of the parts was noted. CONCLUSION: An exchange of the hand piece and gripping end may increase the risk of breakage and retinal damage. The delicate gripping tips, however, may break because of inadequate maintenance and/or aging of the material. Intraoperative visual and functional examination is recommended before intraocular use.
- - - - - - - - - -
ranking = 6
keywords = breakage
(Clic here for more details about this article)

5/7. Coronary air embolism complicating accessory pathway catheter ablation: detection by echocardiography.

    Percutaneous radiofrequency catheter ablation has been recently introduced for treatment of wolff-parkinson-white syndrome. Access to left free-wall atrioventricular accessory pathways can be obtained either via retrograde cardiac catheterization or via the transseptal procedure, which allows ablation of the accessory pathway at its ventricular or atrial insertion, respectively. We describe a patient with wolff-parkinson-white syndrome in whom coronary air embolism occurred as a complication of transseptal percutaneous radiofrequency catheter ablation. The diagnosis was made by two-dimensional echocardiography showing a marked echocontrast effect in the posterior wall and in the posterior half of the interventricular septum. A grossly evident breakage of the rubber seal of the vascular sheath was supposed to be the cause of air insinuation. This report suggests that the transseptal approach should be used with caution in performing percutaneous radiofrequency catheter ablation to avoid the risk of air embolization. Two-dimensional echocardiography is an ideal tool to detect this complication.
- - - - - - - - - -
ranking = 1
keywords = breakage
(Clic here for more details about this article)

6/7. Pupillary block during cataract surgery.

    Sudden phakic pupillary block occurred immediately upon cortical cleaving hydrodissection during cataract surgery in two patients. We believe this unique complication is related to the recent introduction of viscoelastics with properties that enhance the maintenance of the anterior chamber during capsulorhexis. We postulate that the cause of the block was a combination of O-ring capsulocortical and iridocapsular seals that tamponade hydrodissection fluid posteriorly. Additional precipitating factors were diabetes, poorly dilating pupils, and increased vitreous pressure, which may have contributed to the sudden and irreversible nature of this block. If this complication is not recognized, an aqueous misdirection syndrome may ensue, requiring pars plana vitrectomy. Immediate mechanical breakage of the pupillary and capsular block, resulting in an immediate decrease in intraocular pressure from greater than 70 mm Hg, may cause severe retinal vascular damage. These cases stress the importance of mechanical pupil dilation to prevent this serious complication of cataract surgery.
- - - - - - - - - -
ranking = 1
keywords = breakage
(Clic here for more details about this article)

7/7. rupture of coronary artery and cardiac tamponade complicating Wallstent implantation.

    A so-far undescribed complication of Wallstent deployment occurred in a 68-yr-old patient with symptomatic coronary artery disease. The patient had coronary angioplasty to the right coronary artery, complicated by a dissection which necessitated stent implantation. After insertion of one Wallstent, further significant distal disease was observed. An attempt to insert a second Wallstent failed due to inability to retract the constraining membrane and deploy the stent. The stent was withdrawn and another Wallstent was inserted through and distally to the first deployed stent. This time it was not only impossible to retract the membrane but also to withdraw the unimplanted stent. Further attempts to withdraw the stent ended in breakage of the stent delivery system, coronary artery rupture, and cardiac tamponade. The patient was successfully resuscitated and an emergency bypass operation was performed. The mechanism of failure of the Wallstent delivery system is discussed, and recommendations for operators are made.
- - - - - - - - - -
ranking = 1
keywords = breakage
(Clic here for more details about this article)


Leave a message about 'Intraoperative Complications'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.