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Case 70 - A 35-Year-Old Woman with Bleeding from a Right Lower Abdominal Trocar Site

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 35-year-old multiparous woman is taken to the operating room after appropriate counseling and consent for surgical sterilization via bilateral salpingectomy. Her medical history is significant for class II obesity. Her past surgical history is significant for two cesarean sections. She is not taking any medications and has no allegies. A 5 mm trocar was placed using direct entry via an optical trocar in the umbilicus. Two additional laparoscopic trocars were placed in bilateral lower quadrants under direct visualization. Standard abdominal survey was performed and within normal limits. The left tube was resected and removed through the trocar. Attention was turned to the right tube and approximately 250 mL of blood was noted in the right lower quadrant. Suction irrigation was used to remove the blood from the right lower quadrant. There was no further bleeding. The right salpingectomy was completed, and the specimen removed. Intra-abdominal pressure was decreased and an abdominal survey was repeated. All surgical sites were noted to be hemostatic; however, when the right trocar was removed, bleeding from the right trocar site was identified.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 212 - 215
Publisher: Cambridge University Press
Print publication year: 2021

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