Abstract
Worldwide, increasingly complex surgery is being performed laparoscopically; thus, laparoscopic complication rates may be increasing. Reported risks from all complications of laparoscopic surgery are between 1 and 12.5/1000 cases and serious complications in 1/1000 cases. Accurate complication rates of surgery are difficult to obtain as most data are from retrospective studies and may be incomplete. This paper is a 10-year retrospective review of gynaecological laparoscopic complications from 1 January 2003 to 31 December 2012. Data sources are SEMAHELIX Hospital Database, Gynaecology Complications Register, Clinical Governance Records, Complaints and Legal Cases. Recorded complications were classified as diagnostic, sterilisations and therapeutic laparoscopies. Further classifications are as follows: major complications and type of injury (bowel, urological, vascular, other), minor complications and failed sterilisations. Twenty-nine complications were identified from 5128 laparoscopies; total complication rate is 5.7/1000 procedures. Major complication rates are as follows: diagnostic, 2.2/1000; sterilisations, 3.3/1000; and therapeutic, 3.1/1000, subcategorised into bowel 1.4/1000, urological 0.2/1000 and vascular 1.2/1000. Our total complication rate lies within published national rates. Compared to published standards of major complications, diagnostic laparoscopy and laparoscopic sterilisation rates were comparable. Conversely, our therapeutic laparoscopy complication rate was much lower. The highest complication rate was in the failed sterilisation group; however, this rate is within published sterilisation failure rates. Bowel and vascular complications were comparable; minor complication rates were low in all groups.
Similar content being viewed by others
References
Rock JA, Warshaw JR (1994) The history and future of operative laparoscopy. Am J Obstet Gynaecol 170:7–11
Hulka J, Peterson H, Phillips J, Surrey M (1995) Operative laparoscopy: American Association of Gynaecologic Laparoscopists’ 1993 membership survey. J AM Assoc Gynaecol Laparosc 2:133–136
Grimes DA (1992) Frontiers of operative laparoscopy: a review and critique of the evidence. Am J Obstet Gynaecol 166:1062–1071
Querleu D, Chapron C (1995) Complications of gynaecological laparoscopic surgery. Curr Opin Obstet Gynaecol 7:257–261
Jansen FW, Kapitayn K, Trimbos-Kemper T, Herman J, Trimbos JB (1997) Complications of laparoscopy: a prospective multi-center observational study. Br J Obstet Gynaecol 104:595–600
RCOG Green-top Guideline No. 49. Preventing entry-related gynaecological laparoscopic injuries. May 2008. RCOG, London.
Munro MG (2002) Laparoscopic access:complications, technologies and techniques. Curr Opin Obstet Gynaecol 14(4):365–374
Leape LL, Berwick DM (2005) Five years after to err is human what have we learned? JAMA 293(19):2384–2390
Etchells E, O’Neill BM (2003) Patient safety in surgery: error detection and prevention. World J Surg 27(8):936–941
Harkki-Siren P, Kurki TA (1997) A nationwide analysis of laparoscopic complications. Obstet Gynaecol 89(1):108–112
Harkki-Siren P, Sjoberg J, Kurki T (1999) Major complications of laparoscopy: a follow-up Finnish study. Obstet Gynaecol 94(1):94–98
Querleu D, Chapron C, Chevallier L, Bruhat MA (1993) Complications of gynaecological laparoscopic surgery. A French multicentre collaborative study. N Engl J Med 328:1355
Pierre F, Chapron CA (1998) French survey on gynaecological laparoscopy. Hum Reprod 13(7):1761–1763
La Chapelle CF, Bemelman WA, Rademaker BMP, Van Barneveld TA, Jansen FW (2012) A multidisciplinary evidence-based guideline for minimally invasive surgery. Part 1: entry techniques and the pneumoperitoneum. Gynaecol Surg 9:271–282
Hill DJ (1994) Complications of the laparoscopic approach. Baillieres Clin Obstet Gynaecol 8:865–879
Penfield AJ (1985) How to prevent complications of open laparoscopy. J Repro Med 30:660–663
Garry R (1999) Towards evidence-based laparoscopic entry techniques: clinical problems and dilemmas. Gynaecol Endosc 8:315–326
Mäkinen J, Sjöberg J (1994) First experiences from laparoscopically-assisted hysterectomy in Finland 1994. Ann Chir Gynaecol 83:59–61
Varma R, Gupta JK (2004) Failed sterilisation: evidence-based review and medico-legal ramifications. BJOG: an International Journal of Obstetrics and Gynaecology 11:11322–11332. doi:10.1111/j.1471-0528.2004.00281.x
Feste JR, Winkel CA (2009) Is the standard of care what we think it is? JSLS 3(4):331–334
Kreckler S, Catchpole K, McCulloch P, Handa A (2009) Factors influencing incident reporting in surgical care. Qual Saf Health Care 18:116–120
Kachalia A, Kaufman SR, Boothman R, Anderson S, Welch K, Saint S, Rogers MAM (2010) Liability claims and costs before and after implementation of a medical error disclosure program. Ann Intern Med 153(4):213–221
Acknowledgments
The authors would like to thank our Patient Experience Midwife and Patient Safety Advisor for their contributions in the review.
Author contributions
The manuscript was written by the corresponding author (Dr KL Moores) with contribution from the co-author (Mr B Bentick). The authors were directly involved in the data collection, analysis and literature review.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
Funding was not required for the review.
Conflict of interest
The authors declare that they have no conflicts of interests.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Moores, K.L., Bentick, B. Gynaecological laparoscopic injuries: a 10-year retrospective review at a District General Hospital NHS Trust. Gynecol Surg 13, 125–130 (2016). https://doi.org/10.1007/s10397-016-0942-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10397-016-0942-8