Postoperative Complications of Laparoscopic Surgery - Abstract
Laparoscopic surgery is a very common and widely established technique. Benefits include decreased postoperative pain, improved patient satisfaction (including cosmetic results), reduced hospital stays and fewer postoperative complications compared with open techniques. The range of surgical techniques is increasing in complexity and about the kind of patients undergoing these procedures (pluripathological patients, associating co-morbidity). Number of emergency operations performed laparoscopically has been increased as well.
Complications of laparoscopic surgery are mainly divided into three groups: complications derived from pneumoperitoneum, complications caused by the operative procedure and postoperative complications.
Apart from the alterations caused by the pneumoperitoneum (raised intra-abdominal pressure and physiological effects especially within cardiovascular and respiratory systems), which have significant effects on the patient, especially if they are elderly or have associated morbidity, it may cause some complications such as severe hypercarbia, cardio-pulmonary compromise, air embolism or gas migration (subcutaneous emphysema, pneumomediastinum and pneumothorax.
Complications of the operative procedure can be grouped into two categories: complications of access and complications of technique.
Complications of access or trocar entry include: hollow or solid viscus perforation, abdominal wall or major vessel injury, incisional hernia and peritoneal tumor cell implantation.
In case of complications derived from the surgical technique, we can include: hemorrhage, vascular injury, retroperitoneal hematoma, bile leak, bile duct injury, bile peritonitis (with or without a bile duct injury). Postoperative complications include: intestinal perforation, bile leak, retroperitoneal hematoma, pancreatitis, subhepatic abscess and postoperative air embolism. This review discusses the complications that can occur in the postoperative period.