A 49-year-old woman presented to an Emergency Department (ED) with abdominal pain nine hours after discharge following outpatient laparoscopic left oophorectomy. The left oophorectomy procedure involved an umbilical port placed using an Optiport visual trocar, a suprapubic port, and two additional ports laterally. The operative note mentioned no visible injury upon entry into the abdominal cavity, but there were extensive adhesions in the pelvis. Nine hours after discharge, the patient presented to another hospital due to increasing
pain, nausea, and fever. The patient underwent a laparotomy and the surgical team found fecal contamination upon entry into the peritoneal cavity; the surgeons concluded that the most plausible explanation was a trocar injury. The commentary discusses the risk of vascular and bowel injury during peritoneal access for laparoscopy and the importance of patient history and abdominal anatomy when considering approaches to abdominal entry.
- Provider:University of California, Davis, Health System
- Activity Link: https://psnet.ahrq.gov/web-mm/fecal-contamination-peritoneum-laparoscopic-trocar-injury-routine-operation-goes-wrong
- Start Date: 2022-10-26 05:00:00
- End Date: 2022-10-26 05:00:00
- Credit Details: AMA PRA Category 1 Credit™️: 1.0 hours
- MOC Credit Details: ABIM - 1.0 Point; Credit Type(s): Medical Knowledge (ABIM)
ABIM - 1.0 Point; Credit Type(s): Patient Safety (ABIM) - Commercial Support: No
- Activity Type: Enduring Material
- CME Finder Type: Online Learning
- Fee to Participate: No, it's free
- Measured Outcome: Learner Competence, Learner Knowledge, Patient Health
- Provider Ship: Jointly Provided
- Registration: Open to all
- Specialty: Internal Medicine
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