Laparoscopic surgery (keyhole surgery) is generally considered a low-risk procedure and is recognised as an important tool for diagnosis and treatment. Laparoscopic surgeries can be carried out to remove cancer, gall bladder (cholecystectomy), appendix and cysts. It can also be used in surgical procedures such as bowel surgery (colectomy), hernia repairs, hysterectomies, nephrectomy, adrenalectomy, bariatric (weight loss) surgery and anti-reflux treatment.
However things can go wrong during a laparoscopy and mistakes made by a surgeon, anaesthetist or nurse could have devastating consequences for the recovery of a patient.
Mistakes During Laparoscopies (Keyhole Surgery): What Could be Considered Medical Negligence?
Laparoscopic or keyhole surgery, like many surgeries, does come with some risk. As organs are not always as visible compared to an open surgery procedure, tears and cuts can occur. If the mistake is picked up and the damage repaired during the procedure, this, in most circumstances, is not considered medical negligence.
However mistakes or omissions which may indicate negligence during a laparoscopy or keyhole procedure could include:
- Lack of Consent: The failure to fully explain the risks and complications of the procedure to the patient.
- Carrying out keyhole or laparoscopic surgery when open surgery or other treatment would have been more suitable:
Although generally considered lower risk, laparoscopies or keyhole surgery may not be suitable in all situations such as:
- Obese patients
- Where previous surgeries have taken place
- Presence of adhesions
- Where there is extensive bowel distension which may affect the field of view
- Large abdominal or pelvic mass (eg. larger uterus size)
- Surgical mistakes which could result in cuts or burns to tissues and organs:
Mistakes could be made when:
- Inserting a Veress needle or a trocar and / or using the coagulator or grasping forceps could damage or perforate organs such as the oesophagus, stomach, bowels, gall bladder, bile duct, bladder, ureters, fallopian tubes, ovaries or damage tissues and blood vessels. In some cases, the damage is irreparable, resulting in removal of the organs that were damaged by the laparoscope.
- Bowel injuries during a laparoscopy could require further surgery to repair the cut / burn, a bowel resection and the possibility of a stoma. Additional surgical errors which could occur during keyhole or laparoscopic bowel surgery include:
- The failure to remove all diseased parts of the bowel
- Unnecessarily removing healthy parts of the bowel
- The failure to ensure that the parts of the bowel are connected correctly after the diseased part is removed. This is known as anastomosis.
- Tears or other injuries could lead to infections such as peritonitis (an infection of the lining of the abdominal wall) and in serious cases septicaemia and organ failure.
- A haematoma or a hernia may also develop in the area of the surgical incision.
4. Electrothermal (heat) injuries to organs and tissues:
The use of cauterising equipment may release heat which could damage neighbouring organs and tissues. It is important for a surgeon to check for any such damage and repair them.
5. Failing to monitor a patient after the laparoscopy:
A tear or burn will result in symptoms in a patient and it is important the surgeon and hospital staff monitor the progress of their patients’ recoveries and to be prepared to act immediately at any sign of a serious complication. A delay in diagnosing a perforated organ or other issue is associated with a higher risk of septicaemia, open surgery, multiple operations, stoma formation, prolonged hospital stay, and mortality.
Swelling, pain, fever, and nausea are some signs that an injury may have occurred during the procedure and delay in responding to these could have serious and fatal consequences.
6. Failure to monitor a patient for signs of an infection:
As with all surgery, there is a risk of infection and a patient must be monitored for signs of an infection eg peritonitis, a bacterial infection in the intestinal cavity.
7. Misdiagnosis risks:
During a laparoscopy, a surgeon can still misdiagnose or even miss a condition which can result in a delay to treatment which could seriously affect recovery.
8. The failure to manage complications arising from the use of carbon dioxide during the procedure: Serious complications could include gas bubbles entering veins or arteries i.e. risk of embolism.
9. The failure to be aware of the risk of blood clots and to treat these: A blood clot could develop in a vein during the laparoscopy and hospital staff should not only monitor a patient for signs of a clot but be aware of high-risk patients.
10. Failure to treat an allergic reaction to anaesthesia: Delays in treating a patient could have serious consequences for recovery.
Common Keyhole Surgeries or Laparoscopies
Laparoscopic or keyhole surgeries are carried out for a variety of conditions. Some of the most common areas include:
- Appendectomy: to remove a diseased or infected appendix
- Colectomy (bowel resection surgery): a surgical procedure to remove all or part of your colon. It is often carried out to treat conditions such as inflammatory bowel disease (diverticulitis), Crohn’s disease, blockages, cancer.
- Proctosigmoidectomy (Hartmann’s procedure): involves removing diseased and damaged portions of the rectum and sigmoid colon – with closure of the anorectal stump and formation of an end colostomy.
- Polypectomy: The removal of polyps in the colon
- Cholecystectomy or gall bladder removal
- Cancer diagnosis: Laparoscopic diagnoses are possible for liver and pancreatic diseases as well as cancer of the pancreas, liver, stomach, bile duct and gallbladder.
- Stomach surgery: laparoscopic surgical repair of a perforated (ruptured) or bleeding peptic or stomach ulcer and removal of certain stomach tumours are common procedures.
- Anti-Reflux Surgery
- Bariatric or weight loss surgery
- Diagnosis of gynaecological conditions: These include pelvic inflammatory disease (PID), infertility, endometriosis, ectopic pregnancy and ovarian cysts.
- Diagnosis of gynaecological cancers: These include ovarian, cervical, uterine, fallopian tubes cancers.
- Treatment of gynaecological conditions: These include fibroids (benign tumours in or around the uterus), endometriosis, prolapse, removing a pelvic abscess, treating urinary incontinence and removing the uterus (hysterectomy).
- Removal of ovarian cysts
- Treatment of ectopic pregnancy: A laparoscopy can remove the ectopic or the fallopian tube.
- Diagnosis of urological conditions: These include diseases of the kidney, bladder, adrenals, lymph glands, prostate, ureters.
- Diagnosis of urological cancers: These include cancer of the bladder, ureters and kidneys.
- Nephrectomy and partial nephrectomy: The complete or partial removal of a kidney due to cancer, infection or kidney disease.
- Prostatectomy: Removal of the prostate gland to treat prostate cancer.
- Treatment of Renal (kidney) cyst
- Adrenalectomy: Benign tumours and cancers may require removal of the adrenal gland.
- Cystectomy and partial cystectomy: Removal of the bladder, known as a cystectomy, or part of the bladder.
- Lymph node dissection: The removal of the pelvic and retroperitoneal lymph nodes to diagnose and treat cancer such as bladder and testicular cancer.
- Ureterolysis: Ureters may require surgery to free them from surrounding scar-like tissue.
Claim Compensation for Mistakes Made During Keyhole or Laparoscopic Surgery
If you believe you have a claim relating to mistakes made during keyhole surgery, give us a call to speak with one of our specialists. Devonshires Claims’ medical negligence solicitors have experience in dealing with surgical negligence claims as well as other medical negligence claims. They will work with you to achieve the best possible outcome including justice for the harm you suffered, and compensation which adequately reflects the injury, pain, financial losses and the need for further medical treatment and care.
We provide victims of medical negligence with:
- A free no-obligation case evaluation
- A ‘No Win No Fee’ agreement
- Access to our network of medical experts and specialist barristers
- Over 20 years’ experience
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