A comparative study of Foley catheter and suturing to control trocar-induced abdominal wall haemorrhage

Abdominal wall vessel injury occurs with increasing frequency as the practice of laparoscopic surgery becomes wider and trocars become sharper. Precautions for avoiding vessels have been advocated and should be implemented at every laparoscopy. Nevertheless, injury of abdominal wall blood vessels occurs in approximately 2% of cases. Several methods of treatment have been advocated. We compared the efficacy and outcome of suturing and Foley catheter insertion for managing bleeding trocar sites. Both methods controlled haemorrhage effectively, but suturing took 11 min and involved two to four insertions of the needle, whereas the catheter was inserted and set to compress the trocar site in 30 s. Removal of the Foley catheter, 20–24 h later, did not renew the bleeding in any of the patients, and was not associated with aggravation of pain. We recommend that in most cases a Foley catheter should be used to stop bleeding of the abdominal wall.