Complications of 411 laparoscopic urological procedures: A single surgeon experience

Abstract

Objectives:The aim of this study is to review the complications of laparoscopic urological procedures performed using a single surgeon during a 12-year period.Materials and Methods:From June 2004 to May 2017, a total of 411 abdominal urological procedures were performed using the author. They included 250 varicocele ligations, 94 nephrectomies (simple, partial, radical, and nephroureterectomy), 34 adrenalectomies, 22 renal cyst ablation, and 11 pelvic lymph node dissections. Operative and postoperative complications were reviewed and analyzed. The results were analyzed using Chi-squared tests for statistical analysis.Results:A total of 55 complications out of 411 procedures occurred in 26 patients with a total complication rate of 13.4%, 19 were major (4.6%), and 36 were minor (8.8%). Mortality occurred in two patients (0.5%). Conversion to open surgery was done in 5 patients (1.2%) to manage uncontrolled bleeding. Major intraoperative complications included vascular injuries (2.2%), injuries to the diaphragm (0.5%), bowel (0.7%), and pancreas (0.5%). Major postoperative complications included urine leak (0.2%) and pelvic lymphocele (0.2%). Minor intraoperative complications included bleeding during trocar access (4.4%) and subcutaneous emphysema (0.7%), whereas minor postoperative complications included atelectasis (1.2%) and ileus (2.2%).Conclusions:Even though the complications rate in this series was comparable to those of other studies in the literature, yet it remains higher than that of open surgery. The continuing advances in laparoscopic techniques will reduce the complication rate and will pave the way for laparoscopy to replace most currently practiced open surgical urological procedures.

Our Initial Laparoscopy Surgery Experiences in Urinary Cystem: 97 Cases

“…In a study made by Daggülü et al in our country, open surgery passing ratio was reported as 5% (17). In a current study on 411 cases containing different urological laparoscopic procedures, total complication ratio was found 13.4% (18). In the series of Demirel et al containing 228 cases, major vascular injury which is a major complication was found 3.5% and organ injury was 0.87% (19).…”

Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

“…[31] As for LD therapy, vessels damage and subcutaneous emphysema might happen to patients during the process of cyst ablation and establishing pneumoperitoneum. [32] The limited included studies in our meta-analysis and the heterogeneity of some date were two main limitations of this study. Due to the lack of researches on the comparations between AS and LD, we included six articles merely and the patient selection bias, heterogeneity of cyst diameter and follow up time or difference of operator training/experience could also be limitations.…”

Laparoscopic retroperitoneal approach for urinary tract surgery. Predictive factors of complications and conversion to open surgery

“…Other authors report more blood loss, mainly related with the greater complexity of the surgical technique. (16) In an initial study of 200 cases, Rassweiler et al (4) reported 7.5% conversion to open surgery, Gill et al (17) 6.6%, Srivastava et al (3) 3.2%, whereas Al-Otabi et al (18) informed 0.7%. (3,18) Conversion to open surgery is not, necessarily, considered a complication, but it does reflect the learning curve of the surgeon.…”

“…(16) In an initial study of 200 cases, Rassweiler et al (4) reported 7.5% conversion to open surgery, Gill et al (17) 6.6%, Srivastava et al (3) 3.2%, whereas Al-Otabi et al (18) informed 0.7%. (3,18) Conversion to open surgery is not, necessarily, considered a complication, but it does reflect the learning curve of the surgeon. In the study, males, past history of prior surgery, operative time and bleeding turned out to be predictive factors for conversion to open surgery.…”