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Abstract:
Complications after laparoscopic procedures in gynecological and surgical clinics were discussed at a symposium held in Stockholm in September of 2000. According to official and professional records the number of laparoscopic operations has increased, especially in surgical clinics. Although this technique entails many advantages for patients, it is accompanied by an increase in the number of complications, some of which are not seen in open surgery. About ten injuries to vessels in the abdominal wall or the abdominal cavity, leading to major bleeding, occur yearly in the course of insertion of laparoscopic instruments. In about the same number of cases the intestines are perforated. Many gynecological procedures are performed using laparoscopic technique, for instance 90% of sterilizations. In operations of the adnexa, the most common complications are related to introduction procedures. At hysterectomy, complication frequency is not higher in laparoscopic operations than when open or vaginal methods are used. About 70% of cholecystectomies in Sweden are performed laparoscopically. The total number of complications is not higher than in open surgery, but the number of injuries to the common and hepatic ducts is higher after laparoscopic cholecystectomy. The importance of perioperative cholangiogram to prevent such injuries is stressed.