Major complications of operative gynecologic laparoscopy in southern Taiwan

Study Objective. To describe our experience with major complications in gynecologic laparoscopy compared with literature reports. Design. Retrospective study (Canadian Task Force classification IT-3). Setting. Two regional teaching hospitals in southern Taiwan. Patients. One thousand five hundred seven women. Intervention. Gynecologic laparoscopy. Measurements and Main Results. The overall number of major complications in 1507 laparoscopies was 24 (1.6%): 6 bladder injuries, 5 bowel injuries, 4 ureteral injuries, 3 cases of delayed vaginal stump bleeding, 2 cases of post-operative ileus, 2 abscesses, 1 vessel injury, and 1 umbilical hernia. Complication rates were analyzed by type of surgery - laparoscopic-assisted vaginal hysterectomy (LAVH) versus non-LAVH. We correlated clinical outcome with time of recognition and treatment of complications. Our complication rates were similar to those reported in the literature and were not significantly different between LAVH and non-LAVH. Conclusion. Early recognition of injuries, preferably intraoperatively, with immediate appropriate treatment is crucial. It is also important to be alert to early manifestations of complications in the postoperative observation period.