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Prevention and management of bowel injury during gynecologic laparoscopy

an update

Eisner, Isabel S.; Wadhwa, Ruchi K.; Downing, Keith T.; Singhal, Pankaj K.

Current Opinion in Obstetrics and Gynecology: April 30, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/GCO.0000000000000552
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Purpose of review The current article aims to briefly review recent literature on bowel injury in gynecologic surgery with a focus on minimally invasive techniques, strategies for prevention, and management of injury.

Recent findings Recent reviews describe a low incidence of bowel injury that is likely affected by low rates of reporting and inconsistent definitions. The major risk factor for bowel injury is adhesive disease, and assessment and prevention techniques for the presence of adhesive disease are evolving. When bowel injury occurs, prompt diagnosis and intraoperative repair yields more favorable outcomes than delayed diagnosis. Repair can be performed by a gynecologic surgeon, with or without the help of a consultant depending on the extent of the injury and surgeon comfort.

Summary Bowel injury is a potentially catastrophic complication in gynecologic surgery, but its rarity presents a challenge in research. A high index of suspicion and meticulous surgical technique are the cornerstones of managing a bowel injury.

Department of Obstetrics and Gynecology, Good Samaritan Hospital Medical Center, West Islip, New York, USA

Correspondence to Isabel S. Eisner, MD, Good Samaritan Hospital Medical Center, 1000 Montauk Highway, West Islip, NY 11795, USA. Tel: +1 631 376 4163; fax: +1 631 376 3420; e-mail: Isabel.eisner@chsli.org

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