PTU - Polskie Towarzystwo Urologiczne
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Analysis of complications of 736 urological laparoscopic operations. Objectivization of the results
Article published in Urologia Polska 2004/57/1.

authors

Mieczysław Fryczkowski, Jacek Huk, Andrzej Potyka, Andrzej Paradysz
Katedra i Klinika Urologii w Zabrzu Śląskiej Akademii Medycznej w Katowicach
Kierownik kliniki: prof. dr hab. Mieczysław Fryczkowski

keywords

laparoscopy, complications, results objectivization, point score system of the operation difficulties

summary

introduction
The objective estimation of various laparoscopic procedures (LOs) with different grade of operating difficulty in several urological centres is not feasible without a common denominator.
The aim of the study was to introduce recommended by us, point scale of difficulty on the basis of our LOs.
materials and methods
In according to European Point Scale we estimated three fixed components of LOs: technical difficulty (1-7 points), operation risk (1-7 points) and the degree of required concentration (1-7 points). Six levels of difficulty were separated based on these principles. Forth mobile element was learning curve. After 30, 1-3 difficulty level and 20, 4-6 difficulty level LOs of one type we added number of points equal to the following grade of difficulty. We also added one point for retroperitoneal approach. In summary, all 4 components of point scale gain 1 to 7 points.
results
The number of intraoperative complications, conversions and reoperations increase in accordance to the level of the LOs difficulty. The fact, that retroperitoneal LOs had twice complications as intraperitoneal one explains their higher level of difficulty. These results were compared with three other, famous urological centers.
conclusions
1. Recommended point scale of difficulty allows for numerical estimation of four, the most important elements of modern, laparoscopic technique in urology.
2. The point scale of difficulty differentiates urological centers according to technical level advancement and experience in LOs.
3. The higher percentage of unfavourable events in the retroperotoneal LOs in comparison to intraperitoneal LOs in our center is a consequence of higher level of difficulty.

references

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correspondence

Mieczysław Fryczkowski
Katedra i Klinika Urologii ŚAM w Zabrzu
ul. 3 Maja l3/15
41-800 Zabrze.