ABSTRACT
Laparoscopic surgery plays an important role in the treatment of female pelvic floor conditions. Even though laparoscopy carries a lower risk profile when compared with laparotomy, it is not devoid of risk. This chapter explores techniques to prevent, identify and manage complications related to laparoscopic pelvic floor surgery with the latest available evidence and literature.
The importance of surgical proficiency and maintenance of case volume in reducing complication rates is explored. Pre-operative prevention of complications is then discussed including appropriate patient positioning, antibiotic use, bowel preparation and the evidence for Enhanced Recovery After Surgery (ERAS) pathways. Intraoperative complications related to pneumoperitoneum, anaesthesia and obtaining access are reviewed. Specific techniques of identification, management and prevention of certain complications related to laparoscopic pelvic floor surgery are then explored including urinary tract injuries, gastrointestinal injuries, vascular injuries and osteomyelitis.
Finally, monitoring and review of patients in the immediate and longer-term postoperative period should not be underemphasised as early detection of complications can often reduce severity and patient morbidity.
