[Medicolegal risks of celioscopy. Analysis of 32 cases of complications]

An analysis of 200 case records of complications or undesired incidents that happened in the practice of gynaecological surgery and which often gave rise to legal actions either in the criminal or the civil courts, made it possible to extract from these case notes 32 cases where there were medico-legal consequences from laparoscopies that had become complicated. Above all, the relative seriousness of each case had to be considered. More than a third of these cases led to death directly linked to the gynaecological laparoscopy. This furthermore could be responsible for intestinal or vascular complications that had to be treated by intensive resuscitation and by further operative interference carried out as emergencies and by prolonged hospitalisation. After having reported these 32 case histories in detail, the authors analyse the medical consequences of these complications before going on the legal repercussions arising from them. The medico-legal practices that are so important are the ability of the laparoscopist, the standards of his technical equipment and of the anaesthetist, and his taking note of previous operations that have been carried out on the patient. It should not be forgotten, too, that there is a statistically demonstrated risk when laparoscopy sterilization is carried out, because this itself gives rise to claims. Finally, the preventive measures that can be undertaken in order to protect surgeons are outlined. These follow the discovery of an important series of complications which may help them to avoid trouble in their daily practice.