Complications due to laparoscopic procedures performed in the Department of Gynecological Surgery of “Polish Mother’s Health Center” Research Institute in 1991-2010

Introduction: Laparoscopic surgery has evolved very quickly and nowadays plays an important role in contemporary gynecology. This technique presents many advantages over traditional laparotomy, including smaller surgical stress against tissues, reduced postoperative pain, better cosmetic effect and shorter hospital stay as well as recovery period.

Objective: The aim of the study was to analyze intraoperative and postoperative complications due to laparoscopic procedures performed in the Department of Gynecological Surgery of “Polish Mother’s Health Center” Research Institute.

Material and methods: We have analyzed hospital charts of 1359 patients who had been treated with laparoscopy in 1991-2010. The following parameters were evaluated: indications to laparoscopic surgery, type of procedures, intraoperative and postoperative complications.

Results: In 1991–2010, a total number of 1359 laparoscopies were performed in the Department of Gynecological Surgery of “Polish Mother’s Health Center” Research Institute. Most of laparoscopic operations were performed due to benign ovarian tumors (487 – 35.8%). The other indications were: infertility, endometriosis, extrauterine pregnancy, uterine myoma, sactosalpinx. The most common laparoscopic procedures were: chromosalpingoscopy (33.8%), excision of the ovarian tumor (25.2%), adnexectomy (9.4%). Because of technical difficulties or complications, laparoscopy turned into laparotomy in 47 cases (3.5%). The intraoperative complications occurred in 21 cases (1.5%). They were: bleeding into the abdominal cavity – in 10 cases, pneumatosis of the retroperitoneal space – 3 cases, injury of the colon – 1 case, injury of the small intestine – 1 case, injury of the urinary bladder – 1 case, injury of the uterus – 1 case, technical problems – 4 cases. Postoperative complications were found in 119 cases (8.76%) with fever being the most frequent one – 103 cases.

Conclusions:

1. Laparoscopy is a safe and useful alternative technique compared to laparotomy for treatment of some gynecological pathology. Improvement of surgical skills of the medical team resulted in more common use of this procedure for both diagnostic and therapeutic purposes.

2. In the study period, we noticed a decreasing number of intraoperative and postoperative complications, which is comparable to that described by other centers.