European Journal of Obstetrics & Gynecology and Reproductive Biology

Principles of safe laparoscopic entry

Introduction
Laparoscopy is now the preferred approach for performing diagnostic procedures and therapeutic interventions in gynaecology. Minimally invasive surgery is less disabling, reduced hospital stay and more cost effective to health care systems, when compared with conventional open operations [1], [2], [3], [4], [5] and [6]. Although the risk of major complications does not significantly differ between benign gynaecological laparoscopic and conventional open procedures, laparotomy has been associated with a 40% higher risk of minor complications [6]. Most often the risk of complications during laparoscopy occurs during initial entry into the abdominal cavity. The rates of life-threatening complications at the time of abdominal entry are low – 0.4 gastrointestinal iatrogenic injuries and 0.2 major blood vessel injuries per 1000 laparoscopies [7]. However these represent approximately 50% of all serious laparoscopic complications [8] and laparoscopic medico-legal litigations (http://www.piaa.us/LaparoscopicInjuryStudy/pdf/PIAA_2000). Minor complications include extra-peritoneal insufflation, which also occurs prior to the initiation of the intended surgical procedure, and postoperative wound infection.

Article title: Principles of Safe Laparoscopic Entry
Article reference: EURO9373
Journal title: European Journal of Obstetrics and Gynecology
Corresponding author: Dr. Dusan Djokovic
First author: Dr. Dusan Djokovic
Final version published online: 30-MAY-2016
Full bibliographic details: European Journal of Obstetrics and Gynecology (2016), pp. 179-188
DOI information: 10.1016/j.ejogrb.2016.03.040

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