Incidents and accidents of laparoscopy. Apropos 2335 examinations

Major and minor complications of laparoscopy are discussed on the basis of a series of 2335 patients. There were 116 cases of complications of insufflation (injury to blood vessels insufflation of abdominal organs subcutaneous and subperitoneal insufflation). Minor disturbances of heart rhythm and blood pressure were observed in about 30% of patients; in 17 patients these complications were more serious. Injuries to abdominal organs by the laparoscope were observed in 13 cases. Postlaparoscopy complications include mediastinal emphysema hemorrhage at the incision site (3 patients) shoulder pain arm paralysis (3 patients) and infection. Intralaparotomy procedures also have a certain complication rate: hemorrhage at the site of ovarian biopsy (5/150 patients) hemorrhage at the site of tubal sterilization (1/12 patients) burns due to electrocoagulation instruments torsion or infection of cysts (1 patient each) infection after biopsy or methylene blue test (1 patient each). In only 1 case was the complication considered serious; this is attributed to a policy of rigorous indications early diagnosis of complications interruption of the procedure at the slightest untoward occurrence and the presence of an experienced surgeon in the operating room. Laparoscopy is treated as an operative procedure.