Surgical complications in 448 gynecological 3D laparoscopic surgeries adopting the Clavien—Dindo classification

The aim of this study is to present and report the perioperative outcomes, intraoperative, and postoperative complications according to the Clavien—Dindo classification. Clinical data of 448 patients who underwent 3D laparoscopy in a single center over 1 year was retrospectively analyzed, and the postoperative complications were stratified adopting the Clavien—Dindo (CD) classification. During the study period, 448 patients underwent gyneclogical 3 D laparoscopic surgery, TLH (259), laparoscopic myomectomy(104), surgery for endometriosis(20), ovarian cyst(24), and miscellaneous(41). The overall rate of intraoperative complications were 0.9 %. There were two cases of bowel injury (0.4 %), one with intra-operative bladder injury (0.2 %) and one with ureteric injury (0.2 %). In all the above cases, recovery was uneventful and no further intervention was needed. There were no incidences of vascular injury, clinical thromboembolism, ICU admission, or death. The incidence of CD Grade I complications was 1.1 %. There were two cases of postoperative vertigo which was treated with betahistine dihydrochloride. One case each of urinary tract infection and vault infection treated with antibiotics and one case of postoperative dysuria treated with flavoxate hydrochloride. Blood transfusions were required in four patients. The incidence of CD Grade II complications was 2.0 %. Two patients (0.4 %) of TLH underwent vault re-suturing under general anesthesia (CD Grade IIIb). There were no cases of CD Grade IV and Grade V complications. The complication rate in our study compares favorably with those reported by other large studies. The authors believe that a widespread implementation of a common standardized system for reporting of complications is essential for comparability of clinical data.