Complications in laparoscopic gynecologic surgery: analysis of 34 cases

Abstract

OBJECTIVE: To investigate retrospectively the complication rate of gynecological laparoscopies at Peking union medical college (PUMC) hospital over 6-year period. METHODS: 1,769 laparoscopic surgeries were carried out from Jan. 1994 through Oct. 1999. The procedures included 1,421 adnexal surgeries, 52 myomectomies and 296 laparoscopic assisted vaginal hysterectomy (LAVH). Complication was defined as an event that had modified the usual course of the procedure or of the postoperative period. RESULTS: Complications occurred in 34 cases, the overall complication rate was 1.9%. Unintended laparotomies occurred in 6 cases (0.3%). Complication rate was 0.9%, 1.9% and 6.8% in adnexal surgeries, myomectomies and LAVH respectively. 12 (35.3%) complications related to puncture and pneumoperitoneum, including five severe emphysema, 7 injuries to epigastric blood vessels of abdominal wall and omental blood vessel, this figure represented 35.3% of all complications of this series. 5 (14.7%) intraoperative, complications occurred during the laparoscopic surgery (3 severe bleedings, 1 bladder injury and 1 skin burn of leg related to the electrode plate), laparotomy was required in 4 of these cases. 17 (50.0%) complications occurred during postoperative stage: 2 intraperitoneal hemorrhages needing re-laparotomy, 2 bowel complications, 4 nerve paresis and 9 febrile morbidities. CONCLUSIONS: In our experience, operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be overlooked. Complications seems related to advanced procedures such as LAVH.