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Explore Laparoscopic Repair of Full-Thickness Gastric Perforation | Step-by-Step Surgical Technique with 3,306 views, 547 likes, and 0 comments. Experience the impact of this video content that has captured audience attention.

Description: This video demonstrates the laparoscopic management of a full-thickness gastric perforation encountered during deep infiltrating endometriosis surgery. Due to chronic pelvic pain caused by deep-infiltrating endometriosis, the patient had undergone five prior laparoscopic procedures and one laparotomy. During initial abdominal entry, a direct 5-mm trocar was inserted at Palmer’s point, and a gastric perforation was immediately recognized upon inadvertent entry into the stomach. This complication likely occurred secondary to gastric distension with air during anesthesia induction. Following diagnostic exploration and confirmation of the defect, the perforation site is identified and managed with meticulous tissue handling. Primary closure is performed using intracorporeal suturing techniques, with a double-layer repair according to tissue integrity. Additionally, no carbon dioxide insufflation was performed into the peritoneal cavity (or the stomach) during direct trocar entry. The diagnosis of perforation was established by direct visualization using a 5-mm optical system. The video highlights key surgical steps, including defect identification, laparoscopic suturing, contamination control with thorough peritoneal lavage, and final inspection for hemostasis and repair integrity. Key Learning Points: • Immediate recognition and assessment of gastric perforation following direct trocar entry. • Principles of intracorporeal suturing and defect closure • Role of omental patch (Graham patch) in selected cases (not applied in this case) • Final inspection and drain placement considerations Disclaimer: This video is intended for medical education purposes only. Surgical techniques may vary depending on patient anatomy, clinical condition, and institutional protocols. TÜRKÇE Açıklama: Bu video, derin infiltratif endometriozis cerrahisi sırasında karşılaşılan mide tam kat perforasyonunun laparoskopik yönetimini göstermektedir. Derin infiltratif endometriozise bağlı kronik pelvik ağrı nedeniyle hastanın beş kez laparoskopi ve bir kez laparotomi öyküsü mevcuttur. İlk batına giriş sırasında Palmer noktasından direkt 5 mm trokar yerleştirilmiş ve mideye (istemsiz) giriş sonrası gastrik perforasyon hemen fark edilmiştir. Bu komplikasyonun, anestezi indüksiyonu sırasında mideye hava dolmasına bağlı geliştiği düşünülmektedir. Tanısal eksplorasyon ve defektin doğrulanmasının ardından perforasyon alanı dikkatli doku manipülasyonu ile değerlendirilmiş ve yönetilmiştir. Primer onarım, doku bütünlüğüne bağlı olarak çift kat olacak şekilde intrakorporeal sütür teknikleri ile gerçekleştirilmiştir. Ayrıca, direkt trokar girişi esnasında batın (veya mideye) karbondioksit insuflasyonu yapılmamış. 5 mm'lik optik ile yapılan direkt gözlem ile perforasyon tanısı konulmuştur. Video, defektin tanınması, laparoskopik sütür teknikleri, hemostaz ile onarım bütünlüğünün son değerlendirmesi gibi temel cerrahi adımları vurgulamaktadır. Temel Öğrenim Noktaları: • Direkt trokar girişi ile gastrik perforasyonun hemen tanınması ve değerlendirilmesi • İntrakorporeal sütür ve defekt kapatma prensipleri • Seçilmiş olgularda omental yama (Graham yaması) kullanımının rolü (bu olguda uygulanmamıştır) • Son değerlendirme ve dren yerleştirme ile ilgili hususlar Uyarı: Bu video yalnızca tıbbi eğitim amaçlıdır. Cerrahi teknikler hasta anatomisine, klinik duruma ve kurumsal protokollere göre değişiklik gösterebilir. #laparoscopy #gastricperforation #directtrocarinjury #trocarinjury #minimallyinvasivesurgery #surgicaleducation #laparoscopicsuturing #endometriosissurgery #complicationmanagement #emergencysurgery #surgicaltechnique #advancedlaparoscopy #palmer'spoint #intraabdominalinjury #surgicaltraining laparoscopic gastric perforation, direct trocar injury stomach, palmer point entry complication, laparoscopic complication management, gastric injury laparoscopy, minimally invasive surgery complication, intracorporeal suturing technique, laparoscopic repair stomach perforation, emergency laparoscopy, general surgery laparoscopic techniques, endometriosis surgery complication, deep infiltrating endometriosis surgery, trocar related injury, laparoscopy complications management, surgical education laparoscopy, advanced laparoscopy techniques, peritoneal lavage laparoscopy, palmer's point, gastric perforation repair

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