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.
Identify the cause of the bleeding and respond as described below.
The camera magnifies the bleeding alarmingly.
Don't panic.
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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