Perforation: The presence of gross blood, stool, bile, or other unidentified substance on the sharp obturator after withdrawal may indicate perforation of an intra-abdominal organ.
Bleeding: This can occur from a biopsy site, pedicle of a polyp, or other area where tissue has been cut.
Hypothermia: The patient may experience moderate to severe hypothermia if other warming measures, such as forced-air warming or heating blankets, are not used. CO2 is colder than the body temperature.
Preperitoneal Insufflation: CO2 could be insufflated into the preperitoneal tissues, if the veress needle was not completely inserted into the peritoneal sac.
Gas Embolism: Signs include dysrhythmias, tachycardia, cyanosis, and pulmonary edema. Treatment includes stopping the CO2 flow, placing the patient in a left lateral position, hyperventilating with 100% O2, and the anesthesiologist can pass a right CVP catheter to aspirate blood from the right atrium (Durant’s procedure).
Incidental Iatrogenic Injury: Brachial plexus injury can occur after laparoscopic or robotic procedures caused by placement of the equipment attachment or frames.