Complications Laparoscopy
The advantages of the laparoscopic approach for surgical procedures include reduced postoperative pain, shorter hospital stays, rapid return to normal activities, and significant cost savings. This has led to performing more extensive procedures in older and sicker patients with significant coexisting cardiopulmonary disease. However, these procedures present new potentially life-threatening complications that are usually not seen with the traditional “open” approach. It therefore is important that the benefits of laparoscopic procedures are weighed against potential complications. Awareness of these potential complications and knowledge of their management should prevent mortality and reduce morbidity, thus improving patient care and safety. The complications unique to laparoscopic surgery include those related to creation of pneumoperitoneum, patient positioning, and surgical instrumentation. Intraperitoneal carbon dioxide (CO2) insufflation and changes in patient positioning during laparoscopic surgery have several hemodynamic, pulmonary, and endocrine consequences. In addition, several surgical complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum, gas embolization, acute hemorrhage, and bowel or bladder perforation, can occur during the laparoscopic procedure. Postoperative complications include pain, nausea, vomiting, pulmonary impairment, wound infection, peritonitis, delayed hemorrhage, incisional hernia, and metastases at the trocar insertion sites..