We report an unusual complication of laparoscopic esophagectomy for carcinoma. During posterior transhiatal dissection, massive bleeding occurred from the left side of the supradiaphragmatic thoracic aorta. A small tear was clearly visible and temporary bleeding control by packing and pressure with a grasper through one of the trocars was effective. A median laparotomy was performed and the aorta was sutured using a standard laparoscopic needle holder. The esophagectomy was successfully completed through a right thoracic approach. Injury to the intrathoracic aorta may occur during transhiatal dissection of the lower mediastinum. Use of a laparoscopic needle holder allowed to repair the supradiaphragmatic aorta through a laparotomy without the need of patient repositioning for a transthoracic approach.
Injury of the thoracic aorta during laparoscopic esophagectomy / L. Bonavina, D. Bona, G. Saino, M. Nencioni. - In: SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES. - ISSN 1530-4515. - 19:2(2009 Apr), pp. e55-e56. [10.1097/SLE.0b013e3181a02ff3]
Injury of the thoracic aorta during laparoscopic esophagectomy
L. BonavinaPrimo
;D. BonaSecondo
;
2009
Abstract
We report an unusual complication of laparoscopic esophagectomy for carcinoma. During posterior transhiatal dissection, massive bleeding occurred from the left side of the supradiaphragmatic thoracic aorta. A small tear was clearly visible and temporary bleeding control by packing and pressure with a grasper through one of the trocars was effective. A median laparotomy was performed and the aorta was sutured using a standard laparoscopic needle holder. The esophagectomy was successfully completed through a right thoracic approach. Injury to the intrathoracic aorta may occur during transhiatal dissection of the lower mediastinum. Use of a laparoscopic needle holder allowed to repair the supradiaphragmatic aorta through a laparotomy without the need of patient repositioning for a transthoracic approach.Pubblicazioni consigliate
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