[Complications of gynecologic laparoscopy. Multicentric study of 7,604 laparoscopies]

In a series of 7,604 laparoscopic procedures, the authors report one death and a rate of 2.76 per thousand (21 cases) for complications requiring laparotomy. When exclusively diagnostic laparoscopic procedures are considered (1,191 cases) this rate drops to 1.67 per thousand. The likelihood of laparotomy being required is directly related to the degree of importance of the laparoscopic surgical procedure. For major laparoscopic surgery the rate of laparotomy is 4.46 per thousand (18 cases), whereas it is only 0.42 per thousand (1 case) for minor laparoscopic surgery (p less than 0.01). Intestinal injuries represent 52.4% (11 out of 21) of cases requiring laparotomy. The main problem with this type of accident is to recognize them, because in almost half the cases (42.8%; 3 out of 7) the intestinal injury went unseen during the laparoscopic procedure and gave rise to peritonitis. Vascular complications are less frequent and required laparotomy in only 8 cases (38%; 8 out of 21). This low level of complications is yet further proof that laparoscopic surgery is a reliable technique and does not involve a high risk of laparotomy, provided that the surgeon has received specific training.