Skip to main content
  • Poster presentation
  • Published:

A new model of uncontrolled hepatic hemorrhage from trocar insertion simulating iatrogenic lesions during video-assisted surgeries

Background

Visceral iatrogenic lesions during video-assisted surgeries may occur during the blind insertion of trocars. Life-threatening hemorrhage and conversion to open surgery may occur. The use of topical hemostatic agents may control the hemorrhage and avoid the need for laparotomy. Our goal is to develop a model simulating liver injury produced by trocar insertion.

Methods

Ten male Landrace pigs weighing 16–20 kg were anesthetized and submitted to pneumoperitonium using CO2 for introduction of a laparoscopic camera into the abdominal cavity. Under direct vision, the anterior surface of the right hepatic iver lobe was perforated by a trocar. The animals were previously divided into two groups: controls (n = 5) and heparin (n = 5), in which 200 UI/kg heparin was administrated intravenously 10 min before the liver lesion, simulating a coagulopathic scenario. Before (0 min) and 10 or 20 min after induction of the liver lesion, hematologic and hemodynamic parameters including hematocrit (Ht), mean arterial pressure (MAP), cardiac output (l/min) and intra-abdominal blood loss (ml) were determined.

Results

See Table 1 and Fig. 1.

Table 1
figure 1

Figure 1

Conclusion

We conclude that trocar-induced liver injury promotes limited blood loss, discrete hypotension and a minor decrease in cardiac output. The use of heparin promotes a significant increase in blood loss and severe hemodynamic compromise. Both models may be useful to test interventions to stop bleeding and to reverse hemodynamic instability due to uncontrolled hemorrhage.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taha, M., Soares, J., Venerando, P. et al. A new model of uncontrolled hepatic hemorrhage from trocar insertion simulating iatrogenic lesions during video-assisted surgeries. Crit Care 9 (Suppl 2), P122 (2005). https://doi.org/10.1186/cc3666

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc3666

Keywords