VASCULAR COMPLICATIONS OF LAPAROSCOPIC SURGERY

Laparoscopic surgery as an alternative to traditional laparotomies has become an important modality in the management of gynecologic disease s; however, it is not without potential risks. Case reports describe n umerous complications, including ureteral injuries, persistent ectopic pregnancies, hospital readmissions, unintended laparotomies to manage bowel or urinary tract injury, and hemorrhage. We retrospectively ana lyzed 195 women who underwent laparoscopic procedures to determine the frequency and severity of operative complications. Several procedures were often involved, including ablations of endometriosis and endomet riomata, salpingo-oophorectomies, tube-ovarian adhesiolyses, salpingo- salpingostomies, laser uterosacral nerve ablations, and laparoscopical ly assisted vaginal hysterectomies. Four major vascular complications were identified (2%), as well as one uterine perforation (0.5%) and tw o cases of subcutaneous emphysema (1%). There were no deaths. Three (1 .5%) patients had an intraoperative laceration of the epigastric vesse ls during trocar placement, and one (0.5%) had a hematoma of the left common iliac vein that was self-contained Management options included immediate laparotomy versus close observation with or without delayed laparotomy.