Complications of laparoscopic hysterectomy.
OBJECTIVE
To evaluate complications of laparoscopic hysterectomy.


METHODS
A retrospective analysis of complications was tabulated from hospital and office records. Forty-five consecutive patients had laparoscopic hysterectomies from November 1991 to November 1992. Complications were divided into operative, anesthetic, postoperative, nursing, and equipment. Each complication was subjectively graded from mild to severe.


RESULTS
Complication rates by group were: operative 11%, anesthetic 7%, postoperative 16%, nursing 4%, and equipment 56%. Operative complications included one bladder perforation, two superficial epigastric artery perforations, and two subcutaneous emphysema cases. There were three anesthetic complications from fluid overload. Postoperative complications included four patients with periumbilical cellulitis. Three patients, who had laparoscopic supracervical hysterectomies, continued to menstruate. Nursing complications included two transient nerve injuries, one femoral and one peroneal. Equipment complications had the highest incidence; the most common type was bipolar cautery dysfunction (22 of 45). There were two video difficulties and one lost laser tip. There were no cases of death, postoperative ileus, fever, thrombophlebitis, transfusions, urinary tract infections, urinary atony, pneumonia, bowel injuries, ureteral injuries, or atelectasis. All patients were treated as outpatients, and no one was admitted or readmitted. Ninety-eight percent of the complications were mild to moderate, with only 2% (one of 45) severe.


CONCLUSIONS
Overall complication rates are high after laparoscopic hysterectomy, even though the complications are predominantly mild to moderate in severity.
Department of Gynecology, HCA West Paces Medical Center, Medical College of Georgia, Atlanta.
R O
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Schwartz
D000758:Anesthesia / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D009732:Nursing Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013525:Surgical Instruments