Complications During Surgery
Intra-operative complications during this surgery are unusual, but as with any operative procedure, they can occur. These can be related to the laparoscopy, to the operative procedure itself or to pre-existing illnesses in the patient.
- Bleeding is very unusual with these procedures. Blood banking is not routinely practiced preoperatively. Only one patient has required transfusion in over 250 such operations.
- The most common intra-operative complication has little relevance under most circumstances. During the dissection of the esophagus and reduction of a hiatal hernia, a hole can be made in the lining of the thoracic cavity, the pleura. When this occurs, gas in the abdomen for laparoscopy enters the chest cavity. This may make ventilation a little more difficult during the operation, but it is still without risk.
- Perforation of the stomach or esophagus can occur from the instruments used, from the dilating tube used to measure the esophagus during the procedure or because the tissues are very weak. Fortunately, this can almost always be repaired during the laparoscopic procedure by switching to an open procedure without any side effects.
- The spleen is at risk of bleeding during the procedure because of its location. In our experience, no patient has required removal of the spleen (splenectomy) because injuries are usually small and the bleeding is easily stopped.
What are the post-operative complications of this surgery?
Complications following this operation are also unusual. Less than 5% of patients will have a significant complication. Complications are usually related to a delayed perforation of the stomach, which results days after the operation. The instruments used can be traumatic to the tissues at times and lead to crushing of the stomach where it is grasped. The area may later tear and create a small, painful hole or perforation. This can almost always be fixed laparoscopically, via another operation. This complication rarely occurs, because measures are taken to prevent it.