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. 2023 Oct 27;29(11):1255-1260.
doi: 10.14744/tjtes.2023.71829.

Unreported rare but serious complication: Major vascular injuries during bariatric surgery

Talar Vartanoğlu Aktokmakyan  1 , Caghan Peksen  1 , Osman Anıl Savaş  1 , Aziz Sumer  1
Affiliations

Unreported rare but serious complication: Major vascular injuries during bariatric surgery

Talar Vartanoğlu Aktokmakyan et al. Ulus Travma Acil Cerrahi Derg. .

Abstract

Background: The aim of this study was to investigate the incidence, risk factors, clinical presentation, and management of major vascular injuries during bariatric surgery, with a specific focus on the role of different access methods in abdominal cavity entry.

Methods: A nationwide survey was conducted among bariatric surgeons to assess the prevalence of major vascular injuries. A questionnaire was distributed to 365 surgeons through WhatsApp groups of two national bariatric surgery societies, with 76 surgeons completing the survey. The study population included general surgeons practicing bariatric surgery, and the questionnaire consisted of 12 questions.

Results: Among the participants, 16.9% reported experiencing a major vascular injury during bariatric surgery. The majority of injuries (75%) occurred at the trocar entrance, with the remaining cases during the dissection phase. Notably, 66.7% of surgeons used optical trocars for access, while 27.8% employed the Veress needle technique. Early detection varied, with 45% identifying the injury immediately and 30% recognizing it within three minutes. Most injuries (52.4%) were repaired laparoscopically, and only three surgeons sought assistance from cardiovascular surgeons.

Conclusion: Vascular injuries are infrequent but potentially serious complications in laparoscopic bariatric surgery. Understand-ing their incidence, timely recognition, and proper management are crucial to minimize adverse effects. The findings of this study shed light on the patterns of vascular injuries and the potential role of specific access methods, providing valuable insights for enhancing patient safety in bariatric surgery.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Graphic of injured vascular’s names
Figure 2
Figure 2
(a) Diagram of the timing of injury (b) Diagram of injury according to entrance.
Figure 3
Figure 3
Diagram of detection time of vascular injury.
Figure 4
Figure 4
Position of the navel relative to the bifurcation depending on body weight[9]
See this image and copyright information in PMC

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