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INTRA- AND EARLY POSTOPERATWE COMPLICATIONS AFTER 252 LAPAROSCOPIC PROCEDURES
Article published in Urologia Polska 1998/51/4.

authors

Eugeniusz Mięko¶, Henryk Lesiewicz, Józef Howaniec, Zbigniew Trzepizur, Zbigniew Jabłonowski, Czesław Pawlak, Waldemar Różański, Cezary Zydek
Klinika Urologii Instytutu Chirurgii WAM w Łodzi
Kierownik Kliniki: prof. dr hab. med. E. Mięko¶

keywords

laparoscopy urological operations complications

summary

Aim of study. Presentation of types of intra- and postoperative complica-
tions after 252 urological laparoscopic procedures.
Material and methods. Between September 1993 and February 1998, 252
videoscopic surgical procedures were performed at the Department of Urolo-
gy and Department of Surgery Military Medical Academy in ŁódĽ. The most
numerous group was constituted by 131 patients with varicocele. Among them,
2 patients underwent bilateral operation and in 5 intraperitoneal hernioplasty
was performed at the same time. Urine incontinence on exertion in women was
treated via preperitoneal access ? colpourethrosuspension was done in 87 pa-
tients. Nephropexia was performed in 2 women. Videoscopic nephrectomy
was done in 8 patients including 3 cases operated via preperitoneal access. In 17
cases renal cysts were excised, in 10 patients via extraperitoneal access, and in
7 cases transperitoneally. In one patient operated transperitoneally a hepatic
cyst was excised at the same time. Right extraperitoneal adrenalectomy was
performed in 2 patients. Abdominal cryptorchism was operated in 4 patients,
and in 1 case a testis prosthesis was implanted at the same time. In 1 patient
pelvic lymphadenectomy was performed.
Results. Intra- and postoperative complications occurred in 19 patients. In
6 cases they gave rise to conversy The most important intraoperative com-
plications included damage to the bladder wall during colpouretherosuspen-
sion in 3 patients, damage to the peritoneum in 2 patients and damage to the
urethra in 1 women. These complications occurred during the same type of
procedure but in different patients. They required open operation, apart from
damage to the urethra, which was treated by longer catheterisation of the
urinary bladder. In .one patient technical difficulties in access to the cyst of
the upper end of the kidney re±uired lumbotomy.
During postoperative period in 4 cases transient pneumoscrotum was seen
and in 4 cases transient hydrocele on the side of the operated varicocele was
present. In 3 patients treated for varicocele temporary pain in the shoulder
occurred. In 1 woman several weeks post colpouretherosuspension a foreign
body in the urinary bladder was found; it appeared to be a clip which was
removed by cystoscopy.
Conclusions. Urological laparoscopic operations are safe, minimal invasi-
ve and connected with smali number of intra- and early postoperative
complications.

references

  1. [1] Bailey, R. W.: Complications of laparoscopic general surgery. Surgical laparosco-
  2. py. St. Louis, MO: Quality Medical Pubishing INC. 1991,311.
  3. [2] Bard, P. A., Chen, L.: Subcutaneosus emphysema associated with laparoscopy.
  4. Anesth. Analg. 1990, 71,100-106.
  5. [3] Brocki, M., Dancewicz, M., Sapieżko, ]., Kutwin, L., Howaniec,}., Mię-
  6. ko¶, E.: Zabiegi videoskopowe w do¶wiadczeniu I Kliniki Chirurgicznej WAM w Ło-
  7. dzi. Videochirurgia 1996, 2, 6.
  8. [4] Capelouto, C. C, Kavoussi, L. R.: Complications of laparoscopic surgery. Uro-
  9. logy 1993, 42, 2.
  10. [5] Gill, I. S., Kavoussi, L. R., Clayman, R. V., Erlich, R., Evans, R., Fuchs,
  11. G., Gersham, A., Hulbert, J. C, McDougall, E. M., Rosenthal, T., Schues-
  12. sler, W. W., Shepard, T.: Complications of laparoscopic nephrectomy
  13. in 185 patients. Urology 1995,154,479.
  14. [6] Gomar, C, Fernandez, C, Villalonga, A., Nadała, M. A.: Carbon diox-
  15. ide embolism during laparoscopy and hysteroscopy. Ann. Fr. Anesth. Reanim. 1985,
  16. 4, 380.
  17. [7] Gomella, L., Lotfi, M. A., Stone, N. N., Sosa, R. E., Shiman, S., Albala,
  18. D., Manyak, M., Kozminski, M.: Laparoscopic urologic surgery: \mprovement
  19. in outcome. J. Urol. 1993,149, 418A.
  20. [8] Herrwiras, J. M., Ariza, A., Gariado, M.: An unusual complications of laparo-
  21. scopy: Pneumopericardium. Endoscopy 1980,12, 254.
  22. [9] Hogdall, C, Roosen, J. U.: Incarcerated herniae following laparoscopy. Acta
  23. Obsted. Gynecol. Scand. 1987, 66, 735.
  24. [10] Hussain, N. M.: Bilateral pneumothorax associated with laparoscopy: A case re-
  25. port of a rare hazard and a review of the literature. Anesthesia 1973, 28, 75.
  26. [11] Kadar, H., Reich, H., Liu, C. Y., Manko, G. Y., Gimpelson, R.: Incisional
  27. hernias after major laparoscopic gynecologic procedures. Am. J. Obstet. Gyn. 1993,
  28. 168, 1493.
  29. [12] Kavoussi, L. R., Sosa, R. E., Capelouto, C: Complications of laparoscopic
  30. surgery.J. Endourol. 1992,6,95.
  31. [13] McGuire, E. ]., Cespedes, R. D.: Propter diagnosis: A must before surgery for
  32. stress incontinence. J. Endourol. 1996,10,247.
  33. [14] Mięko¶, E., Trzepizur, Z., Otulski, H., Brocki, M., Kutwin, L.: Laparosko-
  34. powa przedotrzewnowa kolpouretrosuspensja w leczeniu wysiłkowego nietrzymania
  35. moczu u kobiet. Gin. Pol. 66,1995,161.
  36. [15] Mięko¶, E.: Powikłania i możliwo¶ci zapobiegania im w laparoskopii urologicznej.
  37. Lek. Wojsk. 1994,11-12, 621.
  38. [16] Mięko¶, E., Trzepizur, Z., Otulski, HL, Brocki, M., Kutwin, L.: Wczesne
  39. wyniki laparoskopowej kolpouretrosuspensji. Gin. Pol. 67,1996,163.
  40. [17] Mięko¶, E.: Chirurgia laparoskopowa w urologii. FAST, ŁódĽ 1997.
  41. [18] Nord, H. J.: Complications of laparoscopy. Endoscopy 1992, 24, 693.
  42. [19] Orlando, R., Lirussi, F., Nassuato, G., Okolicsanyi, L.: Complication of
  43. laparoscopy in the elderly: A report on 345 consecutive cases and Comparison
  44. with a younger population. Endoscopy 1987, 19, 145.
  45. [20] Ou, C. S., Presthus, J., Beadle, E.: Laparoscopic blader neck suspension using
  46. hernia mesh and surgical staples. J. Laparoendosc. Surg. 1993, 3, 563.
  47. [21] Reich, H.: Laparoscopic bowel injury. Surg. Laparosc. Endosc. 1992, 2, 74.