Complications of retroperitoneoscopic surgery at one centre

Objective To evaluate the complications of retroperitoneoscopic urological surgery at one centre and to analyse their causes and means of prevention. Patients and methods The procedural details complications were analysed ret rospectively in and 316 patients (aged 4-88 years) who peritoneoscopic urol ogical surgery underwent between retroperitoneoscopic urological surgery be tween March 1994 and January 2000 at our centre. Nephrectomies and nephrour eterectomies for benign and malignant diseases were the most common procedu res. Other indications included urolithiasis, adrenal diseases, pelvi-urete ric junction obstruction, chyluria, retrocaval ureter and malignant retrope ritoneal lymph node enlargement. The specimens were retrieved intact by enl arging the port sites. Results The mean (range) operative duration was 104.9 (30-400) min, the blo od loss 130.86 (25-1200) mL and the hospital stay 3.2 (1-10) days: 3.5% of the patients had a major complication, including seven vascular injuries, f ive of which required immediate conversion to open surgery. Four patients ( 1.2%) had other major complications including colonic injury, retroperitone al collections and incisional hernia. There were 50 minor complications (15 .8%) of which peritoneal tears (17) were the commonest. Port-site infection s and subcutaneous emphysema contributed 2.2% each. Conclusions As the stages of retroperitoneoscopic surgery become standardiz ed and the outcome predictable, it is rapidly becoming accepted as an impor tant method of treatment. The complications are few and predominantly minor . Increasing experience leads to a decrease in the complication rates. Indi vidual surgeons can identify the common complications in their practice, as certain the possible causes and devise methods of prevention.