Gallbladder surgery leads to severing of aorta leads to leg amputation.

redlight

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wow that's horrible news. i feel bad for them all..

Read, who was stationed at Beale Air Force Base east of Marysville, Calif., was supposed to get his gallbladder removed laparoscopically at the Travis hospital, said his wife, Jessica Read.
Instead, a device being threaded into his belly nicked or punctured the aorta, a large artery that carries blood from the heart throughout the body, she said.

i wonder why they opted for a different procedure..or is the "threading" part of MIS's protocol?
 
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Law2Doc

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wtf? how the hell did he manage to cut the aorta doing a lap chole?
that was some poor-ass surgical technique

The patient perhaps had some very unusual anatomy, or had a predisposing medical condition (aneurism, diabetes, steroid use) making the vessel very weak that it could tear while mobilizing other structures, or else possibly the surgeon was in too much of a rush making his/her port sites, or some combination of the above. You can't really know from this article. There are adjacent structures that unavoidably get nicked in these procedures, but the aorta is usually pretty avoidable in this kind of procedure in an otherwise healthy person with normal anatomy.
 

medking

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The patient perhaps had some very unusual anatomy, or had a predisposing medical condition (aneurism, diabetes, steroid use) making the vessel very weak that it could tear while mobilizing other structures, or else possibly the surgeon was in too much of a rush making his/her port sites, or some combination of the above. You can't really know from this article. There are adjacent structures that unavoidably get nicked in these procedures, but the aorta is usually pretty avoidable in this kind of procedure in an otherwise healthy person with normal anatomy.

Kinda off topic, but Law2Doc, what field of medicine are you doing as I see you're a resident now?
 

SouthernSurgeon

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wow that's horrible news. i feel bad for them all..



i wonder why they opted for a different procedure..or is the "threading" part of MIS's protocol?

I think "threading" was just an odd choice of verbiage by the writer. It is really hard to tell from this article, but I think they mean either a trochar for the lap instruments, or one of the instruments themselves somehow nicked the aorta.
 

BigRedBeta

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The patient perhaps had some very unusual anatomy, or had a predisposing medical condition (aneurism, diabetes, steroid use) making the vessel very weak that it could tear while mobilizing other structures, or else possibly the surgeon was in too much of a rush making his/her port sites, or some combination of the above. You can't really know from this article. There are adjacent structures that unavoidably get nicked in these procedures, but the aorta is usually pretty avoidable in this kind of procedure in an otherwise healthy person with normal anatomy.


I assumed it was port site accident. I've been in an adjacent OR when a trochar has nicked the aorta under the direction of a very experienced surgeon. It is a known risk of any laproscopic procedure in the abdomen, but I think (IIRC - my month on gen surg as an M3 was 2 years ago), the port placements for lap chole's are slightly higher risk because of the use of the umbilicus for access and insufflator attachment.

For those of you unfamiliar with the OR, the initial port placement is generally the most dangerous because it's blind and done without the added assistance of having the belly fully inflated (it may be partially inflated). Once the first port is in, the insufflator pressure is increased, distending the abdominal wall of the internal structures and the laproscope is inserted to visualize the placement and entry of subsequent ports.

Unfortunate that this happened and led to such an extremely poor outcome. But it is a known complication, something that can happen to really good surgeons when the patients have normal anatomy.
 
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