罕見的腹腔鏡手術併發症：由Trocar穿刺所引起之術後腹壁血塊

Trocar related subcutaneous hematoma after laparoscopy surgery

由於腹腔鏡以及內視鏡手術的發展越來越成熟，大部分的婦科良性腫瘤都可以使用腹腔鏡手術做治療。與傳統手術比起來，腹腔鏡手術的好處在於住院時間短、術後疼痛較為輕微、以及恢復較快。在腔鏡手術中，trocar穿刺術是腹腔鏡手術的第一步，因此了解手術器械以及病人的前側腹壁的解剖構造並安全的置入trocar為一個重要的課題。我們在這篇文章討論一名接受腹腔鏡手術的67歲女性，因trocar穿刺術所引起的術後前側腹壁血塊及後續治療過程。

In recent years, the development of minimally invasive surgery has been more and more widely accepted, which has made laparoscopic surgery more mature, and most gynecological tumors can be achieved by laparoscopic surgery. Compared with traditional laparotomy, laparoscopic surgery reduces hospitalization and recovery time and reduces postoperative pain. The learning of laparoscopic surgery not only requires extensive experience and long-term practice, but also requires a full understanding of surgical instruments and anatomical landmarks to reduce the risk of complications. Trocar insertion is a necessary step for laparoscopy surgery. However, this step may result in complications including abdominal wall vessel injury leading to abdominal wall hematoma. We reported a 67-year-old female who received a laparoscopy-assisted vaginal hysterectomy. The patient was complicated with post-operative anterior abdo-minal wall hematoma 3 days after the surgery. In summary, recognizing the anatomical structure by transilluminating the abdomen through a laparoscope can avoid such complications.