Here we report on a case of an external iliac artery injury that occurred during total laparoscopic radical hysterectomy that was managed laparoscopically.
The patient was a 41-year-old woman, gravida 6 para 1, who underwent a total laparoscopic radical hysterectomy for the treatment of clinical stage IB1 cervical adenocarcinoma. The right external iliac artery was lacerated during the monopolar dissection of a broad ligament, which induced severe bleeding. The bleeding was stopped by grasping of the lacerated site with an atraumatic grasper. An endovascular clip was placed both proximal and distal to the lacerated site, which was repaired with an uninterrupted intracorporeal suture. The endovascular clips were then removed and hemostasis was confirmed. The right external iliac artery was occluded for a total of 28 minutes. The laparoscopic surgery did not require a laparotomy.
The patient has since been followed up for 14 months without recurrence or complications in the right lower extremity.
This case demonstrates that we must practice stopping severe bleeding and making efforts to prevent it.
