Articles

ESUT Special Paper

Prevention and Management of Complications in Urological Laparoscopic Port Site Placement

By: Richard J. Pemberton a, David A. Tolley b lowast and Roland F. van Velthoven c

European Urology, Volume 50 Issue 1, November 2006, Pages 958-968

Published online: 01 November 2006

Keywords: Laparoscopy, Port site, Complications, Access

Abstract Full Text Full Text PDF (563 KB)

Abstract

Objectives

To review complications associated with urological laparoscopic port-site placement and outline techniques for their prevention and management.

Methods

Review of the literature using Medline.

Results

Laparoscopy now plays a key role in urological surgery. Its applications are expanding with experience and evolving data confirming equivalent long-term outcome. Although significant port-site complications are uncommon, their occurrence impacts significantly on perioperative morbidity and rate of recovery. The incidence of such complications is inversely related to surgeon experience. Ports now utilise bladeless tips to reduce the incidence of vascular and visceral injuries, and subsequently port-site herniation. Metastases occurring at the port site are preventable by adhering to certain measures.

Conclusions

Whether performing standard or robot-assisted laparoscopy, port-site creation and maintenance is critical in ensuring minimal invasiveness in laparoscopic urological surgery. Although patient factors can be optimised perioperatively and port design continues to improve, it is clear that adequate training is central in the prevention, early recognition, and treatment of complications related to laparoscopic access.

Take Home Message

A wide range of potential complications can occur with placement of laparoscopic ports, with significant impact on perioperative morbidity and convalescence. Urologists should be trained not only in laparoscopic procedures but, importantly, in the prevention and management of such complications.

Keywords: Laparoscopy, Port site, Complications, Access.

Footnotes

a Sir Charles Gairdner Hospital, Perth, Australia

b Scottish Lithotriptor Centre, Edinburgh, United Kingdom

c Department of Urology, Institut Jules Bordet, Brussels, Belgium

lowast Corresponding author. Tel. +44 131 537 1602; Fax: +44 131 537 1020.

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