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

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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.