[Complications of laparoscopic surgery in urology]

More and more laparoscopic procedures are performed in Urology each day. Attempts at reducing the invasiveness of conventional surgical procedures and the possibility of permitting patients to resume their activities earlier have considerably extended the indications for laparoscopy. Laparoscopic access to the urinary system is not simple since it is almost completely located in the retroperitoneal region and peritoneal insufflation with CO2 puts organs that were previously protected within the abdominal cavity at risk. The urologist must operate in a surgical field that was previously unfamiliar to him, with no stereoscopic vision and using instruments without all of the functions of those of conventional surgery. The complications of laparoscopic surgery may present intraoperatively or late postoperatively. Correct patient selection and preparation can prevent many of the complications that arise during trocar insertion. The physiological response to peritoneal insufflation with CO2 must be well understood if the possible complications arising from pneumoperitoneum are to be prevented or correctly treated. The different complications of laparoscopic surgery in Urology are described. The potential problems of the different stages of the procedure, the pathophysiological aspects, prevention and treatment are discussed.