Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 11 , ISSUE 6 ( November-December, 2019 ) > List of Articles


Large Port Site Hematoma Following Laparoscopic Surgery and Its Management

Marie Christine Valerie Mendoza

Keywords : Complication, Laparoscopy, Port site hematoma

Citation Information : Mendoza MC. Large Port Site Hematoma Following Laparoscopic Surgery and Its Management. J South Asian Feder Obs Gynae 2019; 11 (6):397-399.

DOI: 10.5005/jp-journals-10006-1739

License: CC BY-NC 4.0

Published Online: 25-04-2013

Copyright Statement:  Copyright © 2019; The Author(s).


Background: Acute hemorrhage and delayed hematoma formation from laparoscopic port sites are uncommon but can be potentially significant complications. They become evident in days 2 to 6 postoperatively, manifesting as visible bruises, excessive pain, or an asymptomatic drop in hematocrit. Bleeding into the abdominal wall leading to giant abdominal wall hematoma requiring blood transfusion, prolonged hospitalization, and emergency surgical procedures is rare. Case description: A woman who had successful second look laparoscopic surgery following debulking surgery for ovarian malignancy developed a large subcutaneous hematoma. She presented after 25 days of discharge from the hospital and was managed by incision and drainage. Results: Exploration of the wound was done with evacuation of blood clots amounting to 300 cc. There was no identifiable bleeding point. The patient had an unremarkable postoperative course after the incision and drainage and was discharged after 2 days. Conclusion: Sound techniques of port placement along with a thorough understanding of the anterior abdominal wall anatomy are crucial to prevent laparoscopic port site hematoma.

  1. Lee CL, Wu KY, Huang KG, et al. Long-term survival outcomes of laparoscopically assisted radical hysterectomy in treating early-stage cervical cancer. Am J Obstet Gynecol 2010;203(2):165.e1–165e7. DOI: 10.1016/j.ajog.2010.02.027.
  2. Quilici PJ, Greaney EM, Quilici J, et al. Trans abdominal preperitoneal laparoscopic inguinal herniorrhaphy: results of 509 repairs. Am Surg 1996;62(10):849–852.
  3. Mudgal MM, Kothiya PK, Kushwah N, et al. Port site complications following laparoscopic surgeries: a prospective study. Int Surg J 2018;5(2):598–601. DOI: 10.18203/2349-2902.isj20180360.
  4. Epstein J, Arora A, Ellis H. Surface anatomy of the inferior epigastric artery in relation to laparoscopic injury. Clinical anatomy (New York, NY) 2004;17(5):400–408. DOI: 10.1002/ca.10192.
  5. Joy P, Simon B, Prithishkumar IJ, et al. Topography of inferior epigastric artery relevant to laparoscopy: a CT angiographic study. Surg Radiol Anat 2016;38(3):279–283. DOI: 10.1007/s00276-015-1513-9.
  6. Rahn DD, Phelan JN, Roshanravan SM, et al. Anterior abdominal wall nerve and vessel anatomy: clinical implications for gynecologic surgery. Am J Obstet Gynecol 2010;202(234):231–235. DOI: 10.1016/ j.ajog.2009.10.878.
  7. Sriprasad S, Yu DF, Muir GH, et al. Positional anatomy of vessels that may be damaged at laparoscopy: new access criteria based on CT and ultrasonography to avoid vascular injury. J Endourol Soc 2006;20(7):498–503. DOI: 10.1089/end.2006.20.498.
  8. Heppert V, Holz F, Winkler H, et al. Necrosis of the rectus abdominis muscle. complication after ilioinguinal approach. Unfallchirurg 1995;98(2):98–101.
  9. Lavery S, Porter S, Trew G, et al. Use of inferior epigastric artery embolization to arrest bleeding at operative laparoscopy. Fertil Steril 2006;86(719):e13–e14. DOI: 10.1016/j.fertnstert.2006.01.054.
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