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