Serious trocar accidents in laparoscopic surgery: a French survey of 103,852 operations.

The incidence of serious trocar accidents was evaluated from a retrospective French study of 103,852 laparoscopic operations involving almost 390,000 trocars. Seven perioperative deaths occurred (mortality 0.07/1,000), arising almost exclusively from vascular injuries. The incidence of vascular injuries was 0.4/1,000. There were injuries to almost all the abdominal organs and most of the abdominal vascular tree. In the absence of any well-defined safety regulations, the technique of open insertion of the first trocar would appear to be the best means of preventing these accidents.