Published: 2022-09-28

Foley catheter tamponade-an effective and first line management of epigastric port site bleed in laparoscopic cholecystectomy: a study of 23 cases over 20 years

M. S. Ray, Brinda B. Panchal, Digpal H. Thakore, Naresh A. Modi, Vishal A. Patel, Aditya A. Raval, Amandeep K. Singh


Background: To study a simple yet effective surgical technique of management of epigastric port site bleed and how to prevent such an incidental surgical accident in patients undergoing laparoscopic cholecystectomy.

Methods: This is a prospective pilot study done during last 20 years in patients undergoing laparoscopic cholecystectomy, who accidentally developed epigastric port-side bleed. A 22 Fr inflated Foley catheter under traction was used to control the bleeding. After an average 24-48 hours of traction tamponade, the catheter was deflated and removed accordingly.

Results: The 23 patients had a complication of epigastric port bleeding, in which Foley’s catheter tamponade was used. In 22 (99.65%) cases, bleeding was controlled effectively with Foley catheter tamponade. Only in 01 patient bleeding could not be controlled with the usually applied traction, so an enhanced traction was introduced, with our indigenously fabricated external contraption. No case required wound exploration or any other sophisticated means of controlling epigastric port site bleed. There was no mortality.

Conclusions: One of the most common complications of laparoscopic surgery is epigastric port site bleeding, which is an avoidable complication, provided proper procedure is followed in establishing this port.


Laparoscopic, Cholecystectomy, Eepigastric port bleed, Trocar, Tamponade, Foley’s catheter

Full Text:



Bulstrode WN. The vermiform appendix. In: O’Connell P, Bailey H, Love R (eds.). Bailey and Love short practice of Surgery. 25th ed. London, Hodder Arnold. 2008;1211.

Augustine A, Pai M, Shibumon M, Kartik S. Analysis of laparoscopic port site complications; A descriptive study. J Minim Access Surg. 2013;9(2):59.

Saber AA, Meslemani AM, Davis R, Pimentel R. Safety zones for anterior abdominal wall entry during laparoscopy: a CT scan mapping of epigastric vessels. Ann Surg. 2004;(239):182-5.

Girolamo G, Carmelo S, Franco P, Francessco V, Tiziana F, Giuseppe M. Portsite related abdominal wall bleeding in 200 patients after laparoscopic cholecystectomy. World J Gastroenterol. 2006;12(44):7165-7.

Owens M, Barry M, Janjua AZ, Winter AC. A systematic review of laparoscopic port site hernia in gastrointestinal surgery. The Surgeon. 2011;9(4)218-24.

Mettler I, Schmitt EH. Laparoscopy entry and its complications. Gynaecol Endose. 1999;8:283-9.

Abbassi-Ghadi N. A Skull, Trocar injury of abdominal wall vessels: a simple method to stop the haemorrhage. Ann R Coll Surg Engl. 2011;93(7);552.

Fernández EM, Malagón AM, Arteaga I, Díaz H, Carrillo A. Conservative treatment of a huge abdominal wall hematoma after laparoscopic appendectomy. J Laparoendosc Adv Surg Tech. 2005;15(6);634-7.

Fasolino A, Colarieti G, Fasolino MC, Pastore E. Studio comparativo the use of Foley’s catheter and suturing to control abdominal wall haemorrhage provoked by the trochar. Comparative study. Minerva Ginecol. 2002;(54);443-5.

Jones JL, Thompson RJ, Benrubi GI. Suture placement for hemostasis during laparoscopy using the Stamey needle. J Am Assoc Gynecol Laparosc. 1995;2(4);445-7.

Ruiz-Tovar J, Priego-Jimenez P, Paiva-Coronel GA. Use of Foley’s catheter to control port-site bleeding in bariatric surgery. Obes Surg. 2012;22(2);306-8.

Martín-Malagón A, Arteaga I, Rodríguez L, Alarco-Hernandez A. Abdominal wall hematoma after laparoscopic surgery: early treatment with selective arterial transcatheter embolization. J Laparoendosc Adv Surg Tech. 2007;17(6);781-3.

Duckett JR, Tamilselvi A, Jain S. Foley catheter tamponade of bleeding in the cave of Retzius after a Tension Free Vaginal Tape procedure. J Obstet Gynaecol. 2005;25(1);80-1.

Konangamparambath S, Wilkinson JM, Cleveland T, Stockley I. Urinary catheter tamponade to control intra-operative bleeding from the superior gluteal artery: a case report. J Bone Joint Surg Br. 2007;89(1);32-3.