Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery

A. S. Lowham, Charles Filipi, R. A. Hinder, L. L. Swanstrom, K. Stalter, A. DePaula, J. G. Hunter, T. G. Buglewicz, K. Haake

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: This study retrospectively assesses the mechanisms of 13 esophageal or gastric injuries resulting from dilator or nasogastric tube placement during laparoscopic foregut surgery and is intended to assist in determining methods of prevention. Methods: Information regarding esophageal or gastric injury during laparoscopic foregut surgery was obtained from six experienced laparoscopic surgeons. The specific mechanisms of injury were determined by discussion with the operating surgeon and review of the operative reports. Results: Eleven cases of esophageal or gastric perforation occurred during bougie insertion and two perforations occurred secondary to nasogastric tube placement during Nissen fundoplication or Heller myotomy. Five perforations required conversion to open operation for repair including two delayed thoracotomies. The 13 injuries occurred during the performance of 1,620 laparoscopic foregut operations for an overall incidence of 0.8%. Conclusion: Foregut injury resulting from esophagogastric intubation during laparoscopic surgery is more common than expected. Risk factors include esophageal anatomy, intrinsic pathologic changes of the esophagus, and inexperience. Prevention must focus on close communication between the surgeon and anethesiologist and safe techniques of dilator insertion.

Original languageEnglish
Pages (from-to)979-982
Number of pages4
JournalSurgical Endoscopy
Volume10
Issue number10
StatePublished - Oct 1996

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Esophageal Perforation
Laparoscopy
Anesthesia
Wounds and Injuries
Stomach
Fundoplication
Thoracotomy
Intubation
Esophagus
Anatomy
Communication
Incidence
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lowham, A. S., Filipi, C., Hinder, R. A., Swanstrom, L. L., Stalter, K., DePaula, A., ... Haake, K. (1996). Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery. Surgical Endoscopy, 10(10), 979-982.

Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery. / Lowham, A. S.; Filipi, Charles; Hinder, R. A.; Swanstrom, L. L.; Stalter, K.; DePaula, A.; Hunter, J. G.; Buglewicz, T. G.; Haake, K.

In: Surgical Endoscopy, Vol. 10, No. 10, 10.1996, p. 979-982.

Research output: Contribution to journalArticle

Lowham, AS, Filipi, C, Hinder, RA, Swanstrom, LL, Stalter, K, DePaula, A, Hunter, JG, Buglewicz, TG & Haake, K 1996, 'Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery', Surgical Endoscopy, vol. 10, no. 10, pp. 979-982.
Lowham AS, Filipi C, Hinder RA, Swanstrom LL, Stalter K, DePaula A et al. Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery. Surgical Endoscopy. 1996 Oct;10(10):979-982.
Lowham, A. S. ; Filipi, Charles ; Hinder, R. A. ; Swanstrom, L. L. ; Stalter, K. ; DePaula, A. ; Hunter, J. G. ; Buglewicz, T. G. ; Haake, K. / Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery. In: Surgical Endoscopy. 1996 ; Vol. 10, No. 10. pp. 979-982.
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