Initial Report of the Carbon Dioxide Laser Laparoscopy Study Group: Complications

Operative laparoscopy using the CO2 laser is becoming increasingly common in reproductive pelvic surgery. However, to date, characterization of the safety of this technique has been limited. To assess this issue, the reports of the 821 women in the database of the Carbon Dioxide (CO2) Laser Laparoscopy Study Group were reviewed. Procedures performed at laparoscopy included vaporization of endometriosis, adhesiolysis, transection of the uterosacral ligaments, fimbrioplasty, salpingostomy for ectopic pregnancy, ovarian cystectomy, and neosalpingostomy. Ninety (11.0%) were hospitalized overnight, and 22 (2.6%) were hospitalized two or more nights. Operative complications were limited and consisted of 9 cases of intraabdominal bleeding, 3 women with uterine perforation, 1 with a trocar injury to the uterus, and 1 with an omental hematoma. None of these women required laparotomy. One patient underwent laparotomy to rule out small bowel injury, but none was noted. Postoperative complications reported consisted of 2 women with urinary retention and 1 each with postconization bleeding, periumbilical hematoma, acute infectious colitis, and allergic reaction to i.m. Depo Provera. Thus, operative or postoperative complications attributable to performance of operative CO2 laser laparoscopy per se were rare and without clinically significant morbidity or mortality. It is concluded that in experienced hands, CO2 laser laparoscopy can be safely used in the performance of reproductive pelvic surgery. (J GYNECOL SURG 5:269, 1989)