Complications

Abstract

In preparation, whether one is doing a simple nephrectomy or a more complex case, I think one always has to be prepared for complications, the most significant being vascular and bowel-related. As far as vascular injuries are concerned, I always have my laparoscopic suture instruments and the laparoscopic applicators available in the room, not necessarily open, but they should always be in the room. The nice thing about the Lapra-Ty® is that you can get a 5–6-inch length of suture and put a Lapra-Ty on the end of it and you can rapidly sew and follow yourself. For example, let’s say you lacerate the gonadal vein. One important thing, I think, is always to be aware of the colon during kidney and adrenal surgery. Colonic injuries can be devastating. The presentation of a patient with a bowel injury is distinctly different from the presentation of a patient after open surgery. A patient with bowel injuries due to laparoscopic surgery tends to present with unique symptoms. They generally do not have peritonitis, but what they do tend to complain about is pain localized to one trocar site.