Acta Scientific Clinical Case Reports

Case ReportVolume 3 Issue 11

Intraoperative Incidents and Postoperative Complications of Laparoscopy

Abdou Niasse1*, Alpha Oumar Touré1, Abdourahmane Ndong2, Papa Mamadou Faye3, Mamadou Cissé3 and Madieng Dieng1

1General Surgeon, University Aristide Le Dantec Hospital, Dakar, Senegal
2General Surgeon, Regional Hospital of Saint-Louis, Senegal
3General Surgeon, Dalal Jamm Hospital, Dakar, Senegal

*Corresponding Author: Abdou Niasse, General Surgeon, University Aristide Le Dantec Hospital, Dakar, Senegal.

Received: September 01, 2022; Published: October 28, 2022

Abstract

Background: Laparoscopy (or laparoscopy) is a modern surgical approach that has invaded and revolutionized all fields of surgery by introducing the concept of minimally invasive surgery. However, it can be interspersed with incidents and a source of complications of varying severity.

Aim: To describe the prognostic aspects, namely the morbidity and mortality of laparoscopy.

Patients and Methods: We carried out a retrospective study on the interventions carried out under laparoscopy from January 2006 to December 2015 at the general surgery department of the Aristide Le Dantec University Hospital in Dakar and having presented a per and/or postoperative complication. The parameters studied were epidemiological data, nature and classification of complications, management and prognostic aspects.

Results: We collected 842 laparoscopic procedures (84.2/year). Complications (per and postoperative) concerned 102 cases, i.e. 12.1%. We identified 59 intraoperative complications (7%). The sex ratio was 0.9 (28 men/31 women). The average age of the patients was 35 years old with extremes of 12 and 85 years old. The interventions concerned were carried out mainly in regulated programming (48 cases). Intraoperative complications occurred mainly after hepatobiliary surgery, especially cholecystectomy with 45 cases (76.2% of intraoperative complications). The biliary wound was the most frequent (n = 24 or 40.6%). We noted 9 cases (15.3%) of emergency intraoperative complications including 5 ileal wounds (8.9%), 1 cecal wound (1.6%), 2 bleeding from the appendicular artery (3.2%) 1 case (1.6%) of pneumoperitoneum intolerance). Management of intraoperative complications was done under laparoscopy in 44 cases (74.5%). The conversion rate to laparotomy was 25.4% (n = 15): intestinal breach in 8 cases; wound of the common bile duct in 3 cases, 3 cases of intolerance to pneumoperitoneum and 1 case of release of cystic clip. The suites were simple in 47 cases (79.7%). An operative morbidity related to intraoperative incidents of 20.3% was noted (n = 12). Of the 842 patients operated on by laparoscopy during this period, a morbidity of 5.1% was noted (n = 43). The majority was noted after emergency laparoscopy with 30 cases (69.7%). Acute appendicitis was the most frequent indication, in emergency, with 15 cases (34.8%) followed by acute generalized peritonitis with 10 cases (23.2%). Parietal suppuration was the most frequent postoperative complication with 15 cases (35.3%), followed by postoperative peritonitis with 7 cases (16.2%) and deep suppuration with 6 cases (13.9%). Our complications were classified as Dindo and Clavien grade I in 23 cases (53.4%), grade II in 1 case (2.3%), grade IIIb in 17 cases (39.5%), and grade V in 2 cases. (4.6%). The management of postoperative complications was surgical (by laparotomy) in 55.8% of cases (n = 24). The follow-up was simple for 41 patients (93%). Two deaths were noted (1.9%) following postoperative peritonitis.

Conclusion: Although it has many advantages, laparoscopic surgery can be a source of serious complications requiring careful management.

Keywords: Coelioscopy; Laparoscopy; Laparoscopic Per-operative Incident; Laparoscopic Post Opérative Complication; Laparoscopic Cholecystectomy

Bibliography

  1. Descottes B., et al. “Complications de la coelioscopie abdominale sous vidéo-laparoscopie”. Monographies de l’Association Française de Chirurgie, Arnette (Paris) 101 (1999): 7-30.
  2. Touré AO., et al. “Indications et résultats de la laparoscopie au Service de Chirurgie Générale du CHU Aristide le Dantec de Dakar (étude rétrospective sur 280 cas.)”. Chirurgie Bariatrique 93 (2015): 28-34.
  3. Puche P., et al. “Traitement des complications biliaires après cholécystectomie par coelioscopie : étude rétrospective de 27 patients”. Journal de Chirurgie5 (2007): 403-408.
  4. N Kohneh Shahri., et al. “Plaies des voies biliaires lors d’une cholécystectomie sous cœlioscopie : résultat des réparations précoces”. Annales de Chirurgie 130 (2005): 218-223.
  5. Cesario E., et al. “Plaies digestives à l’insertion des trocarts en coelioscopie. Analyse de la base de données de retour d’expérience de Gynerisq”. Journal of Gynecology Obstetrics and Human Reproduction9 (2016): 1083-1090.
  6. Brown K., et al. “laparoscopic gynaecological surgery”. Obstetrics, Gynaecology and Reproductive Medicine 8 (2019): 213-218.
  7. Hashizume M and Sugimachi K. “Needle and trocar injury during laparoscopy surgery in Japan”. Surgery Endoscopy 11 (1997): 1198- 201.
  8. Mc Lucus B and Maech C. “Urachal sinus perforation during laparoscopy. A case report”. Journal of Reproductive Medicine 35 (1990): 573-574.
  9. Llarena NC., et al. “Bowel injury in gynecologic laparoscopy: a systematic review”. Obstetics and Gynecology 125 (2015): 1407-1417.
  10. Schillinger D., et al. “Plaie artérielle épigastrique majeure par l’aiguille de Veress en cours de coelioscopie”. Presse Medicine 16 (1987): 1004.
  11. Henry C., et al. “Résultats du traitement cœlioscopique des urgences abdominales”. Annales de Chirurgie 52 (1998): 223-228.
  12. Parini U., et al. “La cœlioscopie en urgence : étude portant sur 194 cas opérés”. Le Journ de Cœlio-chir 23 (1997): 37-42.
  13. Crist DW and Gadacz TR. “Complications of laparoscopy surgery”. Surgical Clinics of North America 73 (1993): 265-289.
  14. Bruhat MA., et al. “Bouquet de la Jolinière J. La Cœliochirurgie”. EMC, Techniques chirurgicales, Urologie-Gynécologie, 41515,6-1989,38.
  15. Salky BA and Edye MB. “The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes”. Surgical Endoscopy 12 (1998): 911-914.
  16. Cardin JL., et al. “Evaluation prospective des évènements indésirables péri-opératoires en chirurgie laparoscopique”. E-mémoires ANC4 (2015): 50-55.
  17. Champault G., et al. “Appendicectomies : Mac Burney ou laparoscopie ? (100cas)”. Journal de Chirurgie 130 (1993): 5-8.
  18. Cardin JL., et al. “Incidents et accidents peropératoires: suites de 4000 laparoscopies. La série du Club Colio”. Journal de Chirurgie4 (2011): 336-344.
  19. Radunovic M., et al. “Complications of laparoscopic cholecystectomy: our experience from a retrospective analysis”. Open Access Macedonian Journal of Medical Sciences 4 (2016): 641-646.
  20. Roy SN. “The risks of laparoscopic surgery”. Gynecology Surgery 3 (2006): 315-319.
  21. Duca S., et al. “Laparoscopic cholecystectomy. A retrospective analysis of 9542 consecutive laparoscopic operations”. HPB3 (2003): 152-158.
  22. Bruhat MA., et al. “La Cœliochirurgie”. EMC, Techniques chirurgicales, Urologie-Gynécologie 6-1989 (2008): 38.
  23. Cardin JL and Johanet H. “Incidents et accidents périopératoires: suites de 4000 laparoscopies. La série du Club Coelio”. Journal de Chirurgie Viscérale4 (2011): 336-344.
  24. Desccottes B., et al. “Complications de la coelioscopie abdominale sous vidéo-laparoscopie”. Monographies de l’Association Française de Chirurgie, Arnette (Paris) 101 (1999): 7-30.
  25. Clavien AP., et al. “The Clavien-Dindo classification of surgical complications: five-year experience”. Annals of Surgery 250 (2009): 187-196.
  26. Rajesh V., et al. “Risk factors predicting operative mortality in perforated peptic ulcer disease”. Tropical Gastroenterology 24 (2003): 148-150.
  27. Fall EM. “La laparoscopie au service de chirurgie generale du CHU Aristide Le Dantec de Dakar de Janvier 2004 à juin 2008 à propos de 280cas”. Thèse de Doctorat en Médecine N°45 UCAD année 2014, Dakar Sénégal.
  28. Cissé M., et al. “Apport de la cœliochirurgie dans les urgences abdominales chirurgicales chez la femme en période d’activité génitale”. Journal de la Sago 10 (2009): 35-38.
  29. Ou C and Rowbotham R. “Laparoscopic Diagnosis and Treatment of non traumatic acute Abdominal Pain in Women”. Journal of Laparoendoscopic and Advanced Surgical Techniques 10 (2000): 41-45.
  30. Majewski W. “Diagnostic laparoscopy for the acute abdomen and trauma”. Surgical Endoscopy 14 (2000): 930-937.
  31. Perniceni T and Slim K. “Quelles sont les indications validées de la cœlioscopie en chirurgie digestive?” Gastroentérologie Clinique et Biologique 25 (2001): 57-70.
  32. Cissé M., et al. “La laparoscopie en urgence à la clinique chirurgicale de l’hôpital Aristide Le Dantec de Dakar : les 100 premiers cas”. e-mémoires de l'Académie Nationale de Chirurgie3 (2009): 78-81.
  33. Farthoutat P., et al. “Cœlioscopie en urgence à l’hôpital principal de DAKAR : un espoir devenu réalité”. J Coelio-Chire 52 (2004): 73-75.
  34. Kâ O., et al. “La cœliochirurgie dans les affections œsogastroduodénales au CHU A. Le Dantec de Dakar. Indications et résultats à propos de 113 patients”. J Afr Chir Digest 13 (2013): 1421-1425.
  35. Peschaud F., et al. “Indications de la laparoscopie en chirurgie générale et digestive. Recommandations factuelles de la Société française de chirurgie digestive”. Annales de Chirurgie 131 (2006): 125-148.
  36. Casanelli JM., et al. “Bilan de quatre années de chirurgie laparoscopique à Abidjan”. Medecine Tropicale 65 (2007): 481-484.
  37. Golash V and Willson PD. “Early laparoscopy as a routine procedure in the management of acute abdominal pain: a review of 1320 patients”. Surgical Endoscopy 19 (2005): 882-885.
  38. Bickel A., et al. “Laparoscopic cholecystectomy for acute cholecystitis performed by residents in surgery: a risk factor for conversion to open laparotomy?” Journal of Laparoendoscopic and Advanced Surgical Techniques 8 (1998): 137-141.
  39. Farney TL. “Laparoscopically induced hernia”. Surgical Endoscopy 10 (1996): 865.
  40. Gadonneix P., et al. “Le bloc de cœlioscopie opératoire”. Vigot, Paris 175 (1993): 645-646.

Citation: Abdou Niasse., et al. “Intraoperative Incidents and Postoperative Complications of Laparoscopy". Acta Scientific Clinical Case Reports 3.11 (2022): 17-23.

Copyright: © 2022 Abdou Niasse., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US