about the project
Medical news
For authors
Licensed books on medicine
<< Previous Next >>

Ligation of a damaged internal iliac vein and suturing of a damaged common iliac artery

Damage to the common iliac vessels can occur with laparoscopy during the introduction of the trocar and cannula or when the lymph nodes are removed for cancer.


General steps for dressing and suturing


Most often, the right external iliac artery is damaged (as shown here), since most surgeons are better at owning and, accordingly, inject the trocar with the right hand. Below is shown damage to the hypogastric vein. Both lesions are accompanied by heavy bleeding.


The first thing any Hirurg should do is to close the damage to an artery or vein with a finger. Note the proximity of the right ureter and the right common iliac vessels.

Ligation of a damaged internal iliac vein


Each laparotomy instrument set has spongy pads. With their help, it is necessary to squeeze the vessel proximal and distal to the site of damage, be it, as shown, the internal hypogastric vein or the common iliac artery (see Fig. 5). Bleeding from the site of injury should be stopped. You cannot try to suture a large blood vessel with ongoing significant bleeding.


Ligation of a damaged vein can be more difficult than suturing a damaged artery. Ligation of the internal iliac vein may not have any consequences. The figure shows vascular clamps superimposed proximal and distal to the lesion site.
The vein is ligated with synthetic absorbable suture next to the clamps. Over time, collateral venous circulation will develop between the lower limb and the ligated internal iliac vein.

Suturing a damaged common iliac artery


Spongy pads can also be used to stop bleeding from a damaged common iliac artery. Damage to the arterial wall must be sutured. First you need to stop the bleeding. With ongoing bleeding, suturing may not be neat and accurate. Spongy pads, as a rule, are available in laparotomy sets, but special vascular instruments are not. The use of other, not special vascular, clamps (Kelly, Kocher, etc.) on large vessels is a gross mistake.


The figure shows the correct way to restore the common iliac artery. Vascular clamps are applied proximal and distal to the lesion site. After stopping the bleeding, a transverse suture is applied to the wound of the arterial wall with a synthetic non-absorbable monofilament thread 5/0 with an atraumatic needle. The suture material “Prolene” used for operations on the heart and vessels is usually released already on both sides with atraumatic needles. This allows you to impose a continuous seam that turns outward, and not screwed inward. An inwardly sutured seam can alter blood flow, contributing to thrombosis.
<< Previous Next >>
= Skip to textbook content =

Ligation of a damaged internal iliac vein and suturing of a damaged common iliac artery

    This operation is often used in cancer patients for urine diversion. A purely physical feature of the created reservoir is that the urine pressure in the reservoir is lower than in the ureters and the abducting knee, and this eliminates the possibility of urine reflux. This reduces the likelihood of chronic inflammatory kidney disease. The operation avoids the use of outdoor
    METHODOLOGY: 1 The surgeon often encounters small rounded defects in the wall of the inferior vena cava above the bifurcation. They are formed upon separation from the wall of the vein of small venous branches that go to the paracaval lymph nodes and are removed with them. The formation of a defect is accompanied by immediate profuse bleeding. The surgeon’s first action to stop the bleeding is to press the spot
    In some cases, it is necessary to remove a significant portion of the ureter due to its radiation damage and / or chronic inflammation. After such an operation, you should not try to connect the narrowed, irradiated and inflamed ureter with the bladder. In such cases, provided that there is a relatively healthy kidney, it is possible to perform three different reconstructive operations: 1)
  4. Damage to the inner ear (labyrinth)
    Direct damage to the inner ear in peacetime is rare. It is possible mainly with the penetration of sharp objects (pins, pins, etc.) through the eardrum and the windows of the maze. Sometimes direct damage to the inner ear can occur during surgery on the middle ear (wounding of the horizontal semicircular canal or dislocation of the stapes from
    Under the influence of excessive physiological as well as pathological stimuli, the process of adaptation develops in the cells, as a result of which they reach a stable state that allows them to adapt to new conditions. If the limits of the adaptive response of the cell are exhausted, and adaptation is not possible, cell damage occurs. To a certain extent, cell damage is reversible. However, if
  6. Lecture. Damage to the chest and chest organs (help with injuries), 2011
    Terminology Dictionary Classification Closed injuries of the chest wall (First aid, Principles of treatment) Closed fracture of ribs Open injuries (injuries) of the chest and organs of the chest cavity Pneumothorax Hemothorax Nursing care for patients (First aid, First-aid
  7. Damage to internal organs with isolated chest injury and the tactics of an ambulance doctor
    HEART INJURIES A heart wound is damage to the integrity of the heart due to trauma. ETIOLOGY AND PATHOGENESIS Heart injuries are most often associated with stab and stab wounds inflicted by cold steel (dagger, knife, “sharpening” in a criminal environment) or household items (awl, screwdriver, table fork, scissors, etc.), sports inventory (rapier). Among the causes of heart injuries
  8. Correction methods for acute respiratory failure in acute lung injury / acute respiratory distress syndrome with a proven effect on mortality and fan-induced lung damage
    • ???? Ventilation with small respiratory volumes. The use of small tidal volumes can reduce the manifestations of volumotrauma and avoid high transpulmonary pressures. According to the largest multicenter randomized controlled trial conducted by ARDSnet in 41 centers and involving 861 patients, the use of small tidal volumes (6 ml / kg body weight) leads to
  9. How do airway obstruction and superior vena cava syndrome affect general anesthesia?
    1. Premedication: only m-choline blockers are prescribed. The patient in a half-sitting position is transported to the operating room, inhaling oxygen. 2. Monitoring: in addition to standard monitoring, an intra-arterial catheter is installed to measure blood pressure in the direct way (in children, after induction of anesthesia). At least one large-diameter catheter is inserted into the vein of the lower limb, because
  10. Cerebral circulatory disorders: damage to the internal carotid artery
    Blood supply to the brain is provided by the vertebral and internal carotid arteries. The ocular artery departs from the latter in the cranial cavity. The internal carotid artery itself is divided into the anterior and middle cerebral arteries. Vertebral arteries are interconnected and form a basilar artery. It, in turn, is divided into two posterior cerebral arteries. Vertebral Basilar
  11. Abdominal injuries
    In the general structure of mechanical damage in peacetime, injuries and injuries of the abdomen account for 4-5%, and in military conflicts - from 4 to 10%. Closed injuries prevail over open ones (2: 1). The complexity of diagnosing abdominal injuries is due to a significant increase in the number of combined and multiple injuries, the entry of victims of intoxication, shock and
  12. Abdominal injuries
    Closed injuries - occur when bruised, squeezed, etc. Their danger lies in the possible rupture of internal organs (stomach, spleen, liver). Signs: abdominal pain, weakness; the pulse is rapid, weak. Since signs of damage to internal organs do not appear immediately, the victim needs strict rest. First aid. Cold on the stomach. In shock - anti-shock
Medical portal "MedguideBook" © 2014-2019