Basic laparoscopy: Cholecystectomy 07.30.01 Dealing with bleeding

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Under construction 18 02 2008



Basic laparoscopy: Cholecystectomy 07.30.01 Dealing with bleeding

If you meet bleeding.


Blood on the telescope.

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Identify the cause of the bleeding and respond as described below.


The camera magnifies the bleeding alarmingly.


Don't panic.

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Try local pressure with the hook electrode for 2 minutes.


Use pressure with a pledget held in a racquet diathermy forcep for 2 minutes.


Connect the diathermy forcep to the diathermy machine.


Put the suction/irrigator in the subcostal port.


Put the diathermy forcep in the epigastric port.


Grasp a 1-2mm. vessel precisely with forcep and coagulate it.


Grasp a larger vessel with the forcep and wait for 3 minutes to allow spontaneous coagulation.


Dissect out a vessel held in the forcep to allow clipping.


Wait 10 minutes before deciding on an open operation.


For uncontrollable bleeding, do a laparotomy.


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