Complications of laser laparoscopy: Eleven years experience

SummaryAlthough operative laparoscopy is becoming more widespread, there is little information about complications associated with this type of surgery. In Guildford we have audited laser laparoscopy for endometriosis, adhe-siolysis, polycystic ovarian syndrome, ovarian cysts and ectopic pregnancy over an 11-year period (1982–1993). A total of 2344 laser laparoscopies (65% endometriosis and laparoscopic uterine nerve ablation [LUNA], 20% adhesioly-sis, 5% LUNA alone and 10% other) have been performed with a low rate of complications. There have been nine significant complications including four cases of haemorrhage from trocar sites, one trocar bowel injury and one case of severe surgical emphysema. The remaining three complications required a laparotomy due to intra-abdominal haemorrhage from mesosalpinx (1), parametrial vessels (1) and unexplained haemoperitoneum. Bipolar diathermy was not routinely available in the mid 1980s at which time the first two of these haemorrhagic complications occurred. Overall, laparotomy has been required to manage the complication in 1.28 per 1000 cases. There have been no deaths. Laser laparoscopy is safe in experienced hands.