Malpractice lawsuit claims surgeon erred using blind laparoscopic technique.

To See or Not to See During Laparoscopy

Is a blind laparoscopic technique to blame for a routine cholecystectomy that went awry? That's the crux of a lawsuit filed in December 2009 in U.S. District Court in Maryland by a woman who needed emergency surgery after her surgeon nicked her intestines during gallbladder surgery.

In the suit, Gloria Milbourne, of Atlantic, Va., claims that during her pre-operative visit she told surgeon Janet Wasson, MD, of Salisbury, Md., about her previous hysterectomy. However, the medical records for the cholecystectomy performed in March 2007 don't mention the hysterectomy.

Ms. Milbourne and her attorney claim that if the surgeon had been able to see inside the abdomen, she might not have nicked the small intestine that had adhered to a scar just below the navel and the trocar port. During the surgery, Dr. Wasson used a Veress insuflation needle and a 10 mm trocar port and no visualization device for the procedure. Ms. Milbourne's complaint says that since she had adhesions in her abdomen as a result of the hysterectomy, Dr. Wasson should have performed the procedure "at another site in the abdomen or by a different technique, such as the Hassan method where dissection occurs through each layer and the abdomen is entered under direct vision."

The day after outpatient surgery, Ms. Milbourne was in great pain, vomited and had to be taken to the emergency department at Peninsula Regional Medical Center in Salisbury. At the hospital, Dr. Wasson's partner said that Ms. Milbourne's intestines had been nicked during the cholecystectomy and that "'poison was leaking' into her system," according to the complaint, which also names as negligent the Chesapeake Surgery Center in Salisbury.

The night that she went to the emergency department, Ms. Milbourne had to undergo emergency surgery to remove 2 to 3 inches of her intestines through a 9-inch incision that went from her breastbone to her pelvis, says the complaint.

Ms. Milbourne had to stay in the hospital for 14 days with a surgical wound that could not be closed because of the infection in her abdomen. At home, Ms. Milbourne suffered a long recovery and now is often short of breath and can't lift things, according to court documents. Ms. Milbourne's attorney did not reply to a request for comment.

In court documents, Dr. Wasson denies that she was negligent in caring for Ms. Milbourne and denies that she delivered substandard care. Dr. Wasson's attorney said he would not comment on the case because it's still pending. The case is still in discovery, and no trial date has been set.

Kent Steinriede
http://www.outpatientsurgery.net/news/2010/03/10