Dc. Smith et al., A HOSPITAL REVIEW OF ADVANCED GYNECOLOGIC ENDOSCOPIC PROCEDURES, American journal of obstetrics and gynecology, 170(6), 1994, pp. 1635-1642
OBJECTIVE: Our purpose was to review the findings of a Gynecologic End
oscopic Review Committee established to monitor and review operative e
ndoscopic procedures performed by the staff at a large private hospita
l, Swedish Hospital Medical Center, in Seattle. STUDY DESIGN: Hospital
charts of patients undergoing the endoscopic procedures under review
are pulled monthly, and the data are extracted, particularly as relate
d to performance of the procedures, length of surgery and hospitalizat
ion, and occurrence of complications. This study is a compilation of t
he committee's review of a 15-month interval, Jan. 1, 1992, to March 3
1, 1993. RESULTS: Forty-two surgeons performed 227 endoscopic procedur
es on 218 patients, 100 hysteroscopically and 127 laparoscopically. Si
gnificant complication rates were associated with the transhysteroscop
ic operative procedures and with many of the translaparoscopic procedu
res, including oophorectomy, ovarian cystectomy, myomectomy, pelviscop
ic lysis of adhesions, and laparoscopic-assisted vaginal hysterectomy.
CONCLUSIONS: A significant complication rate was found for many of th
e advanced endoscopic procedures performed at Swedish Hospital Medical
Center, This is likely related to operator inexperience in performing
relatively difficult endoscopic procedures involving new and ever-exp
anding arrays of techniques and instruments.