Large subcapsular liver hematoma following single-incision laparoscopic cholecystectomy

Many laparoscopic surgeons are now transitioning from standard multiple-port laparoscopic cholecystectomy to single-incision laparoscopic surgery (SILS) in an attempt to improve cosmetic outcomes and decrease postoperative morbidity. However, little has been published regarding the potential complic...

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Bibliographic Details
Published in:Journal of the Society of Laparoendoscopic Surgeons 2011-01, Vol.15 (1), p.114-116
Main Authors: Hansen, Adam J, Augenstein, Julie, Ong, Evan S
Format: Article
Language:English
Subjects:
Adult
Biliary Dyskinesia - surgery
Blood Transfusion
Case Reports
Cholecystectomy, Laparoscopic - adverse effects
Cholecystectomy, Laparoscopic - instrumentation
Cholecystectomy, Laparoscopic - methods
Female
Hematoma - etiology
Hematoma - surgery
Humans
Intraoperative Complications - etiology
Intraoperative Complications - surgery
Liver - injuries
Liver Diseases - etiology
Liver Diseases - surgery
Reoperation
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Summary:Many laparoscopic surgeons are now transitioning from standard multiple-port laparoscopic cholecystectomy to single-incision laparoscopic surgery (SILS) in an attempt to improve cosmetic outcomes and decrease postoperative morbidity. However, little has been published regarding the potential complications of SILS operations. We report the case of a patient undergoing SILS cholecystectomy who developed the complication of a large hepatic hematoma, resulting in significant postoperative morbidity, blood transfusion requirement, and reoperation. After an in-depth internal review of the postoperative morbidity of this case, it appears that the causative factor may be instrument shaft torque on the liver surface. Single-incision laparoscopic surgery may pose significant and unique risks that warrant additional operative caution. Quantitative comparison of SILS to the gold-standard laparoscopic cholecystectomy is needed to further elucidate definitive benefits and complications of this novel technique.
ISSN:1086-8089
1938-3797
DOI:10.4293/108680811X13022985131615