Ro. Parra et al., COMPLICATIONS OF LAPAROSCOPIC UROLOGICAL SURGERY - EXPERIENCE AT ST-LOUIS-UNIVERSITY, The Journal of urology, 151(3), 1994, pp. 681-684
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.