Urological complications of laparoscopic surgery: Experience with 350 procedures at a single center

Purpose: We assessed our experience with urological complications of laparo scopic surgery in regard to incidence, etiology, treatment and possible pre vention. Materials and Methods: A total of 350 laparoscopic procedures were performe d at our institution between June 1993 and December 1999 in 206 men and 139 women. These procedures included pelvic lymph node dissection in 102, blad der neck suspension in 99, adrenalectomy in 54, varicocelectomy in 23, pyel oplasty in 22, nephrectomy in 20, treatment; of benign renal pathologies, i ncluding cyst, diverticula and calculi, in 13, genitourinary prolapse repai r in 11 and miscellaneous procedures in 6 patients. Complications were eval uated according to the procedure attempted and were listed by incidence and etiology. Results: A total of 19 (5.4%) complications occurred in our series. The ass ociated mortality rate was 0.3% and conversion rate was 1.1%. Most intraope rative complications (2.6%) were vascular (4) and visceral injuries (5), wh ile postoperative complications (2.8%) were predominantly thromboembolism ( 3) and wound infection (2) at trocar sites. The complication rate decreased from 9% for the first 100 to 4% for the subsequent 250 procedures. Conclusions: Critical documentation of complications of laparoscopic surger y is important for further development of the technique and information for urologists in training. Most of our serious complications should be preven table with better mastery of the different procedural steps. However, lapar oscopy must be regarded as major surgery with a significant learning curve.