Major complications of operative and diagnostic laparoscopy for gynecologic disease.
OBJECTIVE
To compare complication rates of diagnostic and operative laparoscopy. Design. Retrospective study (Canadian Task Force classification II-2).


METHODS
One medical center and three teaching hospitals.


METHODS
Six thousand four hundred fifty-one women with various indications for laparoscopic diagnosis and/or laparoscopic surgery from January 1994 through June 1999.


METHODS
Diagnostic and operative laparoscopies.


RESULTS
Forty-two major complications occurred that directly resulted in one death. One patient had stomach injury, 3 had major vessel injuries, 5 had ureter injuries, 10 had intestinal injuries, and 23 had bladder injuries. The overall complication rate for all laparoscopies was 0.65% (42/6451); however, it rose to 0.80% (39/4865) for operative laparoscopy compared with 0.19% for diagnostic laparoscopy (3/1586; p <0.001, Fisher's exact test).


CONCLUSIONS
Laparoscopic surgery is appropriate for managing various gynecologic diseases and has an acceptable complication rate. However, operative laparoscopy should be performed carefully because its rate of complications is significantly higher than that of diagnostic laparoscopy, especially for laparoscopic-assisted vaginal hysterectomy. (J Am Assoc Gynecol Laparosc 8(1):68-73, 2001)
Wang
P H
PH
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan.
Lee
W L
WL
Yuan
C C
CC
Chao
H T
HT
Liu
W M
WM
Yu
K J
KJ
Tsai
W Y
WY
Wang
K C
KC
D002404:Catheterization / Q000009:adverse effects; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007422:Intestines / Q000293:injuries; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects*; D007889:Leiomyoma / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries; D001743:Urinary Bladder / Q000293:injuries; D014594:Uterine Neoplasms / Q000601:surgery