Laparoscopic Management of Complications in Gynecologic Laparoscopic Surgery: A 5-year Experience in a Single Center

Study Objective To evaluate the feasibility and efficacy of laparoscopic management of complications without conversion to laparotomy in gynecologic laparoscopic surgery. Design Retrospective clinical study (Canadian Task Force classification III). Setting University teaching hospital. Patients A total of 2668 women who underwent gynecologic laparoscopic surgeries from March 2003 through February 2008. Interventions Gynecologic laparoscopic surgeries. Measurements and Main Results We investigated major complications during gynecologic laparoscopic surgery. Based on patients’ medical records, we reported types of laparoscopic surgery, types of complication, early recognition of complications, and treatment method of complications. Overall, 33 (1.24%) complications occurred in this study. There were 18 (0.67%) bladder injuries, 6 (0.22%) major vessel injuries, 3 (0.11%) bowel injuries, 3 (0.11%) ureteral injuries, 2 (0.07%) diaphragmatic injuries, and 1 (0.04%) intravesical foreign body. In all, 32 of 33 complications were successfully repaired laparoscopically. In 1 case, rectal perforation occurred on the third day after surgery; Hartmann operation followed by colostomy reversal was performed. Conclusion Laparoscopic management of complications in gynecologic laparoscopic surgery is feasible and efficient.