Our Summary

This paper discusses the potential eye-related complications that can arise during laparoscopic surgery (a minimally invasive surgical technique). Though rare, these complications can sometimes lead to severe visual loss. The main eye problems include corneal abrasions (scratches on the surface of the eye) and perioperative visual loss (loss of vision around the time of surgery). These issues can be caused by a rise in pressure within the eye, certain factors related to anesthesia, and the patient’s individual characteristics.

The authors recommend specific strategies to prevent and manage these eye-related complications during surgery. They provide general tips, as well as specific advice for different types of surgeries, including robot-assisted laparoscopic procedures, spinal surgery, colorectal resection (removal of part of the colon), radical prostatectomy (removal of the prostate gland), and gynecologic surgery.

In conclusion, the authors stress the importance of collaboration between surgeons, anesthesiologists, and eye doctors both in the surgical process and from a legal perspective, with the aim of learning from each other to better manage these complications.

FAQs

  1. What are the potential ocular complications of laparoscopic surgery?
  2. What factors contribute to the onset of perioperative visual loss (POVL) during laparoscopic surgery?
  3. What measures can be taken to prevent and manage ocular complications in laparoscopic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic surgery is to be aware of the potential for ocular complications such as corneal abrasions and perioperative visual loss. Patients should inform their surgical team of any eye conditions or concerns, and follow any recommended precautions during the procedure to minimize the risk of these complications. It is also important for patients to communicate with their healthcare providers about any changes in vision or discomfort after surgery.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those undergoing colorectal resection, radical prostatectomy, gynecologic surgery, robot-assisted surgery, and spine surgery. These patients may benefit from the minimally invasive nature of laparoscopic surgery, which can lead to faster recovery times and reduced postoperative pain. However, it is important to be aware of potential ocular complications, such as corneal abrasions and perioperative visual loss, and take appropriate measures to prevent and manage these issues during surgery. Collaboration between surgeons, anesthesiologists, and ophthalmologists is crucial in order to provide the best possible care for patients undergoing laparoscopic procedures.

Timeline

Before laparoscopic surgery:

  1. Patient is evaluated by a surgeon and anesthesiologist to determine if laparoscopic surgery is the best option for their condition.
  2. Patient undergoes pre-operative testing, such as blood work and imaging studies, to assess their overall health and to plan for the surgery.
  3. Patient is instructed on pre-operative preparations, such as fasting before the surgery and medications to stop taking.
  4. Patient is given anesthesia during the surgery to ensure they are comfortable and pain-free.

After laparoscopic surgery:

  1. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  2. Patient may experience some pain or discomfort at the incision sites, which can be managed with pain medications.
  3. Patient is instructed on post-operative care, such as wound care and activity restrictions.
  4. Patient may experience some side effects of the anesthesia, such as nausea or dizziness, which usually resolve within a few hours.
  5. Patient follows up with their surgeon for a post-operative visit to ensure proper healing and to address any concerns or complications.

What to Ask Your Doctor

  1. What are the potential ocular complications that can occur during laparoscopic surgery?

  2. How common are ocular complications during laparoscopic surgery?

  3. What measures can be taken to prevent ocular complications during laparoscopic surgery?

  4. How are ocular complications typically managed if they do occur during laparoscopic surgery?

  5. Are there any specific considerations or precautions that should be taken for patients with pre-existing eye conditions or risk factors for ocular complications?

  6. What is the role of the anesthesiologist in preventing ocular complications during laparoscopic surgery?

  7. Are there any specific guidelines or recommendations for reducing the risk of ocular complications during robot-assisted laparoscopic surgery or spinal surgery?

  8. How long do ocular complications typically last if they occur during laparoscopic surgery?

  9. Are there any long-term effects or risks associated with ocular complications from laparoscopic surgery?

  10. Is there a need for collaboration between surgeons, anesthesiologists, and ophthalmologists to better manage ocular complications during laparoscopic surgery?

Reference

Authors: Nuzzi R, Tridico F. Journal: Semin Ophthalmol. 2016;31(6):584-92. doi: 10.3109/08820538.2015.1009557. Epub 2015 Apr 30. PMID: 25927166