Complications of Laparoscopic Procedures in Urology: Experience With 2,407 Procedures at 4 German Centers

Fahlenkamp, D.; Rassweiler, Jens; Fornara, Paolo; Frede, Thomas; Loening, Stefan A.

doi:10.1097/00005392-199909010-00038

Cited by 293 publications

(155 citation statements)

References 16 publications

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“…Permpongkosol et al and Fahlenkamp et al have reported general incidences of pancreatic lesions of 0.2-0.4% in their evaluation of complications in urologic procedures [5,7].…”

Section: Pancreatic Injurymentioning

confidence: 99%

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Intraoperative complications of laparoscopic adrenalectomy

2008

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A laparoscopic or retroperitoneoscopic access to the adrenal gland is the standard of care for adrenalectomy in most cases. Although in laparoscopic adrenalectomy the approach is minimally invasive, the procedure is challenging. This is reflected in the scope of possible complications. The surgeon must consider complications related to the anatomical topography of the adrenal gland, which typically encompasses the complications known from open surgery and complications related to the minimal invasive access. In this topic paper we will address the most frequently encountered complications of adrenalectomy: vascular injuries, injuries of the bowel, pleural tears, and injuries to the liver, spleen and pancreas. Fortunately, these complications occur rarely. However, many of these complications can have devastating consequences. Therefore, it's the surgeon's obligation to be aware of the possible complications he might encounter during laparoscopic adrenalectomy. This awareness is essential for their prevention and it helps the laparoscopic surgeon to identify complications intraoperatively. Intraoperative complications of laparoscopic adrenalectomy Conflict of interest None AbstractA laparoscopic or retroperitoneoscopic access to the adrenal gland is the standard of care for adrenalectomy in most cases. Although in laparoscopic adrenalectomy the approach is minimally invasive, the procedure is challenging. This is reflected in the scope of possible complications. The surgeon must consider complications related to the anatomical topography of the adrenal gland, which typically encompasses the complications known from open surgery and complications related to the minimal invasive access. In this topic paper we will address the most frequently encountered complications of adrenalectomy: vascular injuries, injuries of the bowel, pleural tears, and injuries to the liver, spleen and pancreas. Fortunately, these complications occur rarely. However, many of these complications can have devastating consequences. Therefore, it's the surgeon's obligation to be aware of the possible complications he might encounter during laparoscopic adrenalectomy. This awareness is essential for their prevention and it helps the laparoscopic surgeon to identify complications intraoperatively.2

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“…Permpongkosol et al and Fahlenkamp et al have reported general incidences of pancreatic lesions of 0.2-0.4% in their evaluation of complications in urologic procedures [5,7].…”

Section: Pancreatic Injurymentioning

confidence: 99%

“…These injuries are either access related or occur during dissection [5,6]. Most commonly, this happens due to inadequate exposure of the vascular structures leading to either sharp or thermal injury to the vessel.…”

Section: Vascular Injurymentioning

confidence: 99%

Intraoperative complications of laparoscopic adrenalectomy

2008

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“…1 The potential benefits to the patient of less postoperative pain, less blood loss, shortened hospitalization and convalescence, improved cosmesis, and earlier return to normal activity make consideration of these techniques attractive to surgeons and patients. 2 Although bleeding is generally considered a standard risk of surgery, during laparoscopy, this can have dramatic effects on the successful outcome of the procedure. While it is the ambition of every surgeon to limit blood loss and prevent hemorrhage, inadvertent injuries to parenchymal organs can occur.…”

Section: Introductionmentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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Background and Purpose: Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from purified plant starch. MPH accelerates the natural clotting cascade by concentrating clotting factors and proteins on their surface while absorbing aqueous and low molecular weight components from blood. The purpose of this study was to determine the efficacy of MPH in achieving hemostasis in the setting of laparoscopic renal injury. Materials and Methods:In four domestic pigs, 16 laparoscopic renal trocar injuries were created (8 each of 12 and 5 mm). A standard hand-assisted laparoscopic approach was used to each kidney so that two lesions per kidney were randomly created. MPH was applied to each treatment lesion with light pressure maintained for 60 seconds. Four of the 16 lesions, two each of 12 and 5 mm, were allowed to bleed as controls. Hemostasis was defined as no active bleeding or oozing. The animals were sacrificed at the conclusion of the procedure. Results: The mean time to hemostasis for the 12-mm MPH and control lesions was 196.2 Ϯ 53.3 and 372.0 Ϯ 225.6 seconds, while the average blood loss was 8.3 Ϯ 3.7 and 12.0 Ϯ 4.9 g, respectively. For the 5-mm MPH and control lesions, the average time to hemostasis was 100.2 Ϯ 24.8 and 247.0 Ϯ 134.4 seconds, while the average blood loss was 8.3 Ϯ 3.8 and 9.0 Ϯ 0.7 g, respectively. The median number of applications of the MPH for the 5-and 12-mm injuries was 1 and 2, respectively. Conclusions: MPH provided a rapid and effective means of hemostasis for laparoscopic renal parenchymal injuries in this model. Additional evaluation is warranted, however, before general application is advisable.

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“…11 Blood loss during surgery was more in open group as compared to laparoscopic group but none of the patient in present study had major vascular injury requiring blood transfusion.…”

Section: Discussionmentioning

confidence: 51%

Laparoscopic versus open pyelolithotomy: our experience of 40 patients

Choudhary

Jauhari

2017

Int J Res Med Sci

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Background: The development of minimally invasive surgical techniques for the treatment of patients suffering from urinary lithiasis has been greatly dependent on technologic advances in the fields of fiberoptic, radiographic imaging, and lithotripsy (shockwave, ultrasonic, electrohydraulic, and laser). The objective of this study was to compare laparoscopic with open pyelolithotomy in relation to various indices and to ascertain whether laparoscopic surgery has superseded open surgery in modern era.Methods: The study was conducted in Department of Surgery, GSVM Medical College and associated Hospital, Kanpur, Lucknow, India from January 2012 to September 2013. 40 patients who were diagnosed with renal pelvic stones, between the age group of 6-70 years were included in this study. Patients were assigned to either laparoscopy group or open group by a computer generated random number. In present study, all the patients in the laparoscopy group were operated by retroperitoneal approach.Results: The male: female ratio was 2:1. The mean pain score was significantly less in laparoscopic group. Drain removal was done earlier in laparoscopic group. The patient in laparoscopic group stayed less as compared open groups. Of the total patients, who underwent surgery 6 sustained surgical complications in open group and only 1 in laparoscopic group. The patients who had undergone laparoscopic surgery returned to work earlier than those with open.Conclusions: Patients operated by laparoscopic surgery shown a better post-operative recovery course, complaints of less pain and thus required less analgesia, returned to normal routine activity earlier, intra-abdominal drain was removed at a much earlier period as compared to open group patient, this not only reduced morbidity but also because of this patient could be discharged earlier. The complication rates were more in the open group as compared to laparoscopic group in terms of surgical site infection, urine leakage and post-operative fever. Patient satisfaction with cosmesis was more in laparoscopic group as compared to open group (as assessed by visual analogue score).

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Complications of Laparoscopic Procedures in Urology: Experience With 2,407 Procedures at 4 German Centers

Cited by 293 publications

References 16 publications

Intraoperative complications of laparoscopic adrenalectomy

Intraoperative complications of laparoscopic adrenalectomy

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Laparoscopic versus open pyelolithotomy: our experience of 40 patients

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