Abstract
Since the dawn of Japanese laparoscopic surgery at our hospital, we have made an effort to pioneer the latest equipment. We have performed 4, 069 laparoscopic cases in 16 years and reported a variety of complications at a single center. All cases were performed using an open-method. The ratio of gasless-to-gas methods in the cases was 6-to-4. We used a uterine manipulator in all cases, except the pregnant cases. We evaluated patients who had complications associated with laparoscopy within 5 days of surgery.
The rate of all complications was 2.58% (105/4, 069) . Three patients (0.074%) had urinary tract injuries, 3 patients (0.074%) had intestinal injuries, and 2 patients (0.049%) had vascular injuries in the pelvis. However, the only severe consequences of the complications involved a nephrectomy after a ureteral injury. Twenty-four of the patients (0.59%) were febrile postoperatively and 17 patients (0.42%) had wound hematomas. None of these cases had any severe consequences. We had one case that required a blood transfusion intraoperatively.
The rate of laparoscopic complications is reported to range between 0.5% and 3%. In our hospital, there was a similar incidence of complications, but there were fewer severe complications. The rate of unintended laparotomy was 1.74% (71 cases) because of severe adhesions, obesity, and unexpended hemorrhage.
We believe that this report will be of use to gynecologists with an interest in reducing the number of gynecologic laparoscopic surgeries.
