For a study, researchers wanted to determine the frequency, location, origin, and mortality of significant vascular injuries during gynecologic laparoscopy for benign purposes. A total of 997 papers were evaluated for inclusion, with 147 full-text publications assessed. About sixty-six studies from 1978 to 2016 passed the inclusion criteria, covering 197,062 procedures. The selected articles reported on the occurrence of significant vascular damage during gynecologic laparoscopy for benign causes. Exclusion criteria included gynecologic malignancy surgery, duplicated data, case series and reports, publications written in a language other than English, and research published solely as abstracts.
Injuries to the aorta, inferior vena cava, iliac (common, external, or internal), and inferior epigastric arteries were documented, as were injuries that were labeled as significant but were not otherwise characterized. There were 179 significant vascular injuries recorded, with a 0.09% (95% CI: 0.08–0.10) frequency. The inferior epigastric vessels were the most frequently damaged vessels (0.04%, 95% CI: 0.03–0.05), accounting for 48% (95% CI: 40–55) of all injuries. The majority of injuries (82%, 95% CI: 76–89) occurred during the abdominal entrance, with the remainder occurring during surgical dissection (18%, 95% CI: 11–24). The majority of injuries were identified intraoperatively (93%, 95% CI: 87–100), and almost half (55%, 95% CI: 46–63) required a laparotomy to be repaired. Only two of the 179 significant vascular injuries resulted in death, with an overall vascular injury mortality rate of 0.001% (95% CI: 0.000–0.004).
The research indicated that the incidence of significant vascular damage during gynecologic laparoscopy is quite low, and the great majority of injuries did not end in mortality. When done for benign gynecologic illness, laparoscopy was a safe surgical procedure in terms of vascular damage.
Reference:journals.lww.com/greenjournal/Abstract/2021/03000/Laparoscopic_Major_Vascular_Injuries_in.9.aspx
