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Intraoperative Events 

Intraoperative Events
Chapter:
Intraoperative Events
Author(s):

Mohammad Alsulaimy

, and Adel Alhaj Saleh

DOI:
10.1093/med/9780190608347.003.0009
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date: 28 January 2022

Various potentially catastrophic complications can occur intraoperatively during the performance of a laparoscopic bariatric procedure. They can be divided broadly into laparoscopic access injuries and complications related to pneumoperitoneum. Most injuries occur at the time of abdominal access for camera and port placement. Access injuries can be attributed to Veress needle and/or trocar insertions. Injuries can occur to vessels (major and minor) with significant hemorrhage, solid organs (liver, spleen), and viscera. Such injuries can be devastating and are a source of significant morbidity and mortality related to laparoscopic bariatric surgery. Abdominal insufflation can cause hemodynamic and pulmonary-related complications. This chapter discusses the prevention, recognition, and management of such complications. Furthermore, the bariatric surgeon may face unexpected intraoperative findings of hiatal hernia, abdominal wall defects, and liver cirrhosis—a discussion of the management of such scenarios is also included.

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