COMPLICATIONS OF LAPAROSCOPIC UROLOGICAL SURGERY - EXPERIENCE AT ST-LOUIS-UNIVERSITY

A total of 221 patients underwent laparoscopic surgery at our institut ion. An outcome analysis with regard to type of procedure, success and complications was done. Overall, 216 of 221 procedures (97.7%) were p erformed as originally planned. One operation was converted to an open procedure. Complications producing morbidity occurred in 33 of 217 pa tients (15.2%). There was no associated mortality. Most complications occurred early in the participating surgeons experience. Of the compli cations 11 (5.0%) were considered major and included formation of symp tomatic lymphoceles (4 patients), vascular injury (1), ureteral transe ction (1), bladder perforation (1), bowel obstruction (1), cecal perfo ration (1) and cerebrovascular accident (I). One patient had an idiopa thic reaction to the inhalation anesthetic. Of the 11 major complicati ons 9 occurred among 98 patients undergoing pelvic lymphadenectomy and 7 of these occurred among a subset of 15 patients undergoing an exten ded dissection. Adjuvant surgical intervention was necessary in 13 pat ients: celiotomy in 5, laparoscopic techniques in 4 and minor surgical procedures or percutaneous techniques in 4. Our experience suggests t hat urological laparoscopic surgery is safe and offers a shorter conva lescence. However, the technique must be regarded as major surgery, as sociated with a steep learning curve.