ABSTRACT
In a large series of 29 966 laparoscopic gynecology cases, the overall complication rate was 4.64 per 1000 cases.1 The proportions of bowel, vascular, and urologic complications were 34.5%, 32.4%, and 27.4%, respectively. A multi-institutional review of 2407 urologic laparoscopic surgeries showed an overall complication rate of 4.4%; intraoperative vascular injuries were the most common (1.7%), followed by visceral injuries (1.1%).2 The risk of complications can be predicted by the complexity of the laparoscopic procedure (ranging from 0.8 to 13.6%); however, a significant decrease in risk was observed with greater surgeon experience, decreasing 4-fold after the first 100 cases.2 Improved laparoscopic skills by experienced surgeons also result in a higher rate of pure laparoscopic repair of these complications.1 With retroperitoneoscopic procedures, the open conversion rates decreased from 10 to 4% as operator experience increased.3 The surgical skills required for complex laparoscopic procedures, including intracorporeal suturing and dissection, are the same skill-set necessary for managing complications.
