Complications of operative laparoscopy

Abstract

Objective To assess the incidence and type of laparoscopic complications. Design A series of 1649 operative laparoscopies were reviewed in a retrospective study of patient records. Setting A tertiary care university hospital. Interventions Operative laparoscopy including minor procedures (minimal adhesiolysis, destruction of minimal endometriosis foci, ovarian biopsy, ovarian puncture, tubal sterilization); major laparoscopic surgery (extended adhesiolysis, tuboplasties, uterine suspension, treatment for ectopic pregnancy, salpingitis, ovarian cyst, moderate and severe endometriosis), and advanced laparoscopic surgery (hysterectomy, myomectomy, bladder neck suspension). Results There was one major vascular complication, two intestinal injuries, one anaesthesiological complication and two urinary tract injuries. In addition there were two minor and five postoperative complications. The overall complication rate was 13/1649 (0.8%). The major complication rate was 6/1649 (0.36%). Conclusions This review has been useful in helping surgeons to reduce the risk of injuries and to inform patients about possible complications. These rates were similar to those that have been previously reported.

Laparoscopic assisted vaginal hysterectomy for benign uterine pathology: is it time to change?

“…It was also noted that adhesions from previous surgery, pelvic infections and endometriosis predispose to injuries (14). Miranda et al in 2000 reported one major vessel injury, two intestinal injuries (0.2%), one anaesthetic complication and two urinary tract injuries (0.2%) in a series of 1649 operative laparoscopies (15).…”

Secondary hemorrhage after different modes of hysterectomy

“…The median interval for the TLH group was 13 days, and for the TAH and VH groups, it was 11 days. Of the few reported cases in literature, the time interval varied from 3 to 18 days [1,2,4].…”

“…Although the overall incidence of secondary hemorrhage is low, gynecologists do come across secondary hemorrhage of varying degrees of severity [1]. There are few studies which show the overall incidence of hemorrhage of 0.2-2 % after hysterectomy which includes reactionary and secondary hemorrhage [1][2][3][4]. Our centre has been performing laparoscopic hysterectomies since 1994, and we encounter one or two cases of secondary hemorrhage per year in the second or third postoperative week which necessitates hospitalization and active treatment.…”

Les complications de la cœliochirurgie dans le service de gynécologie A de l’hôpital général de Yaoundé, Cameroun

“…Il a été rapporté par la plupart des études que sa morbidité per-et postopératoire reste faible avec un taux de complications de 0,27 à 1,97 % [2,3,5,8,[11][12][13][14]. Ce taux a été un peu plus élevé dans notre série : 2,46 % (Tableau 4).…”

“…Les complications mineures étaient de 1,8 % dans notre série et les majeures de 0,66 %. Ce dernier taux reste élevé par rapport à celui des grandes séries [2,13,14]. Cela pourrait s'expliquer par le fait que nos patientes ont très souvent des adhérences (78,16 %), ce qui majore le risque de complication aussi bien lors de l'installation de la coelioscopie que pendant le geste opératoire.…”