腹腔镜胆囊切除术医源性并发症TME

I have try to explain what happened from my point of view.
First my mistake was that I touched the wall of IMA with harmonic in its entrance area in 2-3 mm from aorta during lymph node dissection. But not for the all thickness of the wall but only to intima.
I didn't notice that.
I made the second uncertain move with the clipator jaw while I try to clipate IMA. I poked a hole in the intima in the same place that I had touched it before. As the result we have the bleeding from IMA in 2-3 mm from the aorta wall.
I was ready for the stitch if I had not succeed the coagulation of IMA. As EnSeal hemostasis showed reliability I decided to let well enough alone.

                               
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