Complications of Laparoscopic Urological Surgery: Experience at St. Louis University

Abstract

A total of 221 patients underwent laparoscopic surgery at our institution. An outcome analysis with regard to type of procedure, success and complications was done. Overall, 216 of 221 procedures (97.7%) were performed as originally planned. One operation was converted to an open procedure. Complications producing morbidity occurred in 33 of 217 patients (15.2%). There was no associated mortality. Most complications occurred early in the participating surgeons experience. Of the complications 11 (5.0%) were considered major and included formation of symptomatic lymphoceles (4 patients), vascular injury (1), ureteral transection (1), bladder perforation (1), bowel obstruction (1), cecal perforation (1) and cerebrovascular accident (1). One patient had an idiopathic reaction to the inhalation anesthetic. Of the 11 major complications 9 occurred among 98 patients undergoing pelvic lymphadenectomy and 7 of these occurred among a subset of 15 patients undergoing an extended dissection. Adjuvant surgical intervention was necessary in 13 patients: celiotomy in 5, laparoscopic techniques in 4 and minor surgical procedures or percutaneous techniques in 4. Our experience suggests that urological laparoscopic surgery is safe and offers a shorter convalescence. However, the technique must be regarded as major surgery, associated with a steep learning curve.

Staging of Pelvic Lymph Nodes in Neoplasms of the Bladder and Prostate by Positron Emission Tomography with 2-[¹⁸F]-2-Deoxy-<i>D</i>-Glucose

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Complications of retroperitoneoscopic surgery at one centre

“…[4] highlighted the growing interest in retroperitoneoscopy, which now accounts for half of all laparoscopic urological procedures. As laparoscopy gains wider acceptance in urology, there are more reports on the potential complications [4–11]. We evaluated the complications associated with retroperitoneoscopic urological surgery at our centre, and analysed their causes and means of prevention.…”

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