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Vascular Complications

  • David Michael Hatcher
  • René Sotelo
Chapter

Abstract

Vascular complications are among the most common and potentially devastating complications to arise in the perioperative setting. These include vascular injuries during initial access and intraoperatively, postoperative bleeding, and thromboembolic events. Rapid, safe, and effective identification and management of these issues are crucial in minimizing harm to the patient. Vascular injuries occurring in the minimally invasive setting present a unique challenge, though the principles of repair remain the same: adequate exposure, proximal and distal vascular control, and repair. Equipment should be available in the operating room in the event of a vascular injury including an open tray, laparoscopic and robotic needle drivers, gauze sponges, vascular clamps, hemostatic agents, and a “rescue stitch.” Management of bleeding may ultimately require blood transfusion, open conversion, angioembolization, or reexploration. The occurrence of these complications can be minimized through careful patient selection, adequate preoperative planning, knowledge of the surgical anatomy, and precise surgical technique.

Keywords

Vascular injury Vascular complications Bleeding Management Access injury Veress needle injury Trocar injury Thromboembolic complications Robotic surgery Minimally invasive surgery 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.USC Institute of Urology, Keck Medicine of USCLos AngelesUSA
  2. 2.USC Institute of Urology, University of Southern CaliforniaLos AngelesUSA

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