Clinical Analysis: A Study On Causes And Prevention Of Gynecological Laparoscopic Surgery Complications

To study the cause of the complications of gynecological laparoscopic surgery in order to reduce and prevent them. A retrospective study was carried out on the clinical data of the 2475 patients who had gynecological laparoscopic surgery in our hospital from the January 2004 to the October 2010 .All of the datas were collected from the case hospital of these patients.The incidence rate of complications were analysised by the ratio and compared the incidence rate with the literature by the chi square test .Among them, The 279 patients with complications was among the 2475 patients (11.27%). there were 10 cases of hemorrhage(0.4%), 1 case of continuity ectopic pregnancy(0.04%, cornual pregnancy),4 cases of intestinal injury(0.16%),1 case of bladder injury(0.04%),1case of ureteral injury(0.04%),118cases of subcutaneous emphysema(4.77%),10 case of pelvic pyogenic infection(0.4%), 7cases of neural injury(0.28%),114cases of shoulder pain(4.60%),4 cases of blurring vision(0.16%),5cases of skin electric injury(0.2%),1cases of the uterine tube exodus from the vagina incisal margin(0.04%),3case of incisional hernia(0.12%). Among these complications,there was 1 case in which laparotomy was needed,7 cases a second laparoscopic surgery was needed.There was 234 cases in 2004.1-2006.12,and 45cases in 2007- October 2010.the total incidence rate of complication in 2007-2010 was lower than the rate in 2004.1-2006.12.Among the total ,the subcutaneous emphysema and the shoulder pain were significantly decreased .Complications are still a big concern despite that laparoscopic surgery is a minimally invasive surgery. The causes of result in complication were that had not perfection of operation techniques,at initial stage of carrying out laparoscopic surgery, had not a fine field vision of exposing during the operation, puncture location was wide, blind operation before distinguishing anatomic structure, severity adhesions of abdominopelvic cavity, cut contamination, gas residual in peritoneal cavity, and the puncture location wasn't avoided the parietal vessel. We had decreased the incidence rate of complication by improving the techniques.So we think the standardize training of doctors, more experience in operation techniques,choosing the right indications a sufficient knowledge on instruments, adopting the effective intervention andproofing the effectiveness during the clinical practice are the keys to decrease the incidence rate of complication and the probability laparotomy.