An audit of complications of complex operative gynaecological laparoscopy at a tertiary healthcare facility in South Africa

C N Omile, S.R. Ramphal, J Moodley
In: South African Journal of Obstetrics and Gynaecology · 2021 · vol. 26(3) , pp. 115 · doi:10.7196/sajog.1640 · W3211747578
article OA: diamond CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This retrospective audit of 446 complex gynecological laparoscopic surgeries found a 4.3% complication rate, with intestinal injury being the most common intraoperative issue.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-09-03 · read from full text ⓘ

This retrospective chart review analyzed 446 patient records to evaluate intra- and postoperative complications associated with complex operative gynaecological laparoscopy at a South African tertiary facility between 2004 and 2016. The study found that surgery for extensive endometriosis and laparoscopic-assisted vaginal hysterectomy were the most common procedures, each accounting for nearly 30% of cases. Complications occurred in 4.3% of patients, including minor vascular injuries and major organ damage such as intestinal, ureteric, or bladder injuries, with a significant portion occurring during abdominal entry. This paper is centrally about endometriosis — specifically, it identifies extensive endometriosis as one of the two most frequent indications for complex laparoscopic surgery within its studied cohort.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Background. Operative laparoscopic surgery has many advantages over traditional/open laparotomy. However, it is also associated with complications particularly when performed for complex gynaecological procedures. There are very few reports on operative laparoscopic surgery from developing countries. Objective. To evaluate the intra- and postoperative complications associated with laparoscopic surgery performed for complex gynaecological conditions by a single surgeon at a tertiary institution. Method. This was a retrospective chart review of patients who underwent complex laparoscopic surgery between 2004 and 2016. Results. We retrieved 446 patient records. Surgery for extensive endometriosis (29.8%) and laparoscopic-assisted vaginal hysterectomy (29.8%) were the most common procedures. Less than a tenth of patients (4.3%; n=19) had complications, 9 had minor injuries (4 inferior epigastric vessel injury, 1 peritoneal vessel injury, 1 omental vessel injury, 1 surface tissue bleeding and 2 cases of postoperative ileus) and 10 had major injuries (6 intestinal, 2 ureteric and 3 bladder). More than a quarter of complications (26.3%; n=5) occurred at the time of abdominal entry, 63.2% (n=12) occured intraoperatively and 10.5% (n=2) occurred postoperatively. All entry injuries were vascular. Intestinal injury was the most common intraoperative complication. Conclusion. Despite the many advantages of laparoscopic surgery, complications occur particularly in patients with complex gynaecological pathology.
Full text 2,312 characters · extracted from oa-doi-fallback · click to expand
Research An audit of complications of complex operative gynaecological laparoscopy at a tertiary healthcare facility in South Africa Abstract Background. Operative laparoscopic surgery has many advantages over traditional/open laparotomy. However, it is also associated with complications particularly when performed for complex gynaecological procedures. There are very few reports on operative laparoscopic surgery from developing countries. Objective. To evaluate the intra- and postoperative complications associated with laparoscopic surgery performed for complex gynaecological conditions by a single surgeon at a tertiary institution. Method. This was a retrospective chart review of patients who underwent complex laparoscopic surgery between 2004 and 2016. Results. We retrieved 446 patient records. Surgery for extensive endometriosis (29.8%) and laparoscopic-assisted vaginal hysterectomy (29.8%) were the most common procedures. Less than a tenth of patients (4.3%; n=19) had complications, 9 had minor injuries (4 inferior epigastric vessel injury, 1 peritoneal vessel injury, 1 omental vessel injury, 1 surface tissue bleeding and 2 cases of postoperative ileus) and 10 had major injuries (6 intestinal, 2 ureteric and 3 bladder). More than a quarter of complications (26.3%; n=5) occurred at the time of abdominal entry, 63.2% (n=12) occured intraoperatively and 10.5% (n=2) occurred postoperatively. All entry injuries were vascular. Intestinal injury was the most common intraoperative complication. Conclusion. Despite the many advantages of laparoscopic surgery, complications occur particularly in patients with complex gynaecological pathology. Authors' affiliations C N Omile, Department of Obstetrics and Gynaecology, School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa S Ramphal, Department of Obstetrics and Gynaecology, School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa J Moodley, Department of Obstetrics and Gynaecology, School of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa Full Text PDF (168KB)Cite this article Article History Date published: 2021-11-04 Article Views Full text views: 1345

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (3)

References (20)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK