Injury to the left liver lobe with bleeding
- Treatment with electrocoagulation, argon beam, application of hemostatics, suture; possible conversion
Perforation of the esophageal wall
- if suspected:
> Injection of a dye solution via nasogastric tube
> also allows detection of very small wall damages with lumen opening
> depending on defect size, laparoscopic oversewing up to conversion with open repair
Intraoperative pneumothorax
- Cause: Pleural lesion during mobilization of the lower esophagus in the mediastinum, through which CO2 can enter the pleural cavity
- is only significant in the presence of cardiopulmonary problems
Patient stable:
- Continue the procedure without thoracic drainage
- after releasing the pneumoperitoneum, rapid resolution of the pneumothorax is expected
Patient unstable (= increasing ventilation pressure, poor oxygenation)
- Reduction of intra-abdominal pressure, possibly complete release of CO2
- if oxygenation remains poor: thoracic drainage and continuation of the procedure
- Conversion to open procedure rarely necessary