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Laparoskopische Eingriffe in der Gynäkologie

Intra- und postoperative Komplikationen

Laparoscopic interventions in gynecology

Intra- and postoperative complications

  • Gynäkologie aktuell
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Die Laparoskopie stellt für Patienten ein schonendes und wenig belastendes Operationsverfahren dar und hat in den letzten Jahrzehnten stark an Bedeutung gewonnen. Heutzutage werden minimal-invasive Verfahren sowohl zur Diagnostik als auch zur Therapie der meisten gynäkologischen benignen und malignen Erkrankungen angewandt. Ähnlich den Vorteilen, welche diese Methode bietet, bestehen auch zugangsspezifische intra- und postoperative Komplikationen. Über diese speziellen Komplikationen im Rahmen laparoskopischer gynäkologischer Operationen gibt die Arbeit einen Überblick und stellt Maßnahmen sowie Algorithmen und klinische Standards zur Prävention, zur Diagnose und zur Therapie derselben vor.

Abstract

During the past decades, laparoscopic techniques have gained more and more significance as minimally invasive treatment options. Nowadays, these procedures are used for diagnosis and treatment of most benign and malignant gynecological diseases. In addition to the advantages of minimally invasive techniques, access-specific intra- and postoperative risks and complications also exist. This article gives an overview of complications in laparoscopic gynecologic procedures, and introduces measures, algorithms, and clinical standards for the prevention, diagnosis, and treatment of these.

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Literatur

  1. Cho JE, Liu C, Gossner G, Nezhat FR (2009) Laparoscopy and gynecologic oncology. Clin Obstet Gynecol 52(3):313–326

    Article  PubMed  Google Scholar 

  2. Jernigan AM, Auer M, Fader AN, Escobar PF (2012) Minimally invasive surgery in gynecologic oncology: a review of modalities and the literature. Womens Health 8(3):239–250

    Google Scholar 

  3. Rimbach S, Neis K, Solomayer E, Ulrich U, Wallwiener D (2014) Current and future status of Laparoscopy in gynecologic oncology. Geburtshilfe Frauenheilkd 74(9):852–859

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Radosa JC, Radosa MP, Mavrova R, Rody A et al (2013) Five minutes of extended assisted ventilation with an open umbilical trocar valve significantly reduces postoperative abdominal and shoulder pain in patients undergoing laparoscopic hysterectomy. Eur J Obstet Gynecol Reprod Biol 171(1):122–127

    Article  PubMed  Google Scholar 

  5. Magrina JF (2002) Complications of laparoscopic surgery. Clin Obstet Gynecol 45:469

    Article  PubMed  Google Scholar 

  6. Molloy D, Kaloo PD, Cooper M, Nguyen TV (2002) Laparoscopic entry: a literature review and analysis of techniques and complications of primary port entry. Aust N Z J Obstet Gynaecol 42(3):246

    Article  PubMed  Google Scholar 

  7. Philips PA, Amaral JF (2001) Abdominal access complications in laparoscopic surgery. J Am Coll Surg 192:525

    Article  CAS  PubMed  Google Scholar 

  8. Trottier DC, Martel G, Boushey RP (2009) Complications in laparoscopic intestinal surgery: prevention and management. Minerva Chir 64:339

    CAS  PubMed  Google Scholar 

  9. Radosa MP, Meyberg-Solomayer G, Radosa J, Vorwergk J, Oettler K, Mothes A, Baum S, Juhasz-Boess I, Petri E, Solomayer EF, Runnebaum IB (2014) Standardised registration of surgical complications in laparoscopic-gynaecological therapeutic procedures using the clavien-dindo classification. Geburtshilfe Frauenheilkd 74(8):752–758

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Mayol J, Garcia-Aguilar J, Ortiz-Oshiro E et al (1997) Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion. World J Surg 21:529

    Article  CAS  PubMed  Google Scholar 

  11. Chandler JG, Corson SL, Way LW (2001) Three spectra of laparoscopic entry access injuries. J Am Coll Surg 192:478

    Article  CAS  PubMed  Google Scholar 

  12. Jansen FW, Kolkman W, Bakkum EA et al (2004) Complications of laparoscopy: an inquiry about closed- versus open-entry technique. Am J Obstet Gynecol 190:634

    Article  PubMed  Google Scholar 

  13. Fuentes MN, Rodríguez-Oliver A, Naveiro Rilo JC, Paredes AG, Aguilar Romero MT, Parra JF (2014) Complications of laparoscopic gynecologic surgery. JSLS. https://doi.org/10.4293/JSLS.2014.00058

    PubMed  PubMed Central  Google Scholar 

  14. Stany MP, Farley JH (2008) Complications of gynecologic surgery. Surg Clin North Am 88(2):343–359. https://doi.org/10.1016/j.suc.2007.12.004

    Article  PubMed  Google Scholar 

  15. Ates S, Tulandi T (2013) Malpractice claims and avoidance of complications in endoscopic surgery. Best Pract Res Clin Obstet Gynaecol 27(3):349–361

    Article  PubMed  Google Scholar 

  16. Makai G, Isaacson K (2009) Complications of gynecologic laparoscopy. Clin Obstet Gynecol 52(3):401–411

    Article  PubMed  Google Scholar 

  17. Hein HA, Joshi GP, Ramsay MA, Fox LG, Gawey BJ, Hellman CL, Arnold JC (1997) Hemodynamic changes during laparoscopic cholecystectomy in patients with severe cardiac disease. J Clin Anesth 9(4):261–265

    Article  CAS  PubMed  Google Scholar 

  18. Saidi MH, Vancaillie TG, White AJ, Sadler RK, Akright BD, Farhart SA (1996) Complications of major operative laparoscopy. A review of 452 cases. J Reprod Med 41(7):471–476

    CAS  PubMed  Google Scholar 

  19. Mavrova R, Radosa JC, Wagenpfeil G, Hamza A, Solomayer EF, Juhasz-Böss I (2016) Learning curves for laparoscopic hysterectomy after implementation of minimally invasive surgery. Int J Gynaecol Obstet 134(2):225–230

    Article  PubMed  Google Scholar 

  20. Wattiez A, Soriano D, Cohen SB et al (2002) The learning curve of total laparoscopic hysterectomy: comparative analysis of 1647 cases. J Am Assoc Gynecol Laparosc 9:339–345

    Article  CAS  PubMed  Google Scholar 

  21. Lim PC, Kang E, Park DH (2011) A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol 120(3):413–418

    Article  PubMed  Google Scholar 

  22. Lim PC, Kang E, Park DH (2010) Learning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer. J Minim Invasive Gynecol 17(6):739–748

    Article  PubMed  Google Scholar 

  23. Fuller J, Ashar BS, Carey-Corrado J (2005) Trocar-associated injuries and fatalities: an analysis of 1399 reports to the FDA. J Minim Invasive Gynecol 12(4):302

    Article  PubMed  Google Scholar 

  24. Nordestgaard AG, Bodily KC, Osborne RW Jr, Buttorff JD (1995) Major vascular injuries during laparoscopic procedures. Am J Surg 169(5):543–545

    Article  CAS  PubMed  Google Scholar 

  25. Yuzpe AA (1990) Pneumoperitoneum needle and trocar injuries in laparoscopy. A survey on possible contributing factors and prevention. J Reprod Med 35(5):485

    CAS  PubMed  Google Scholar 

  26. Larson GM, Vitale GC, Casey J, Evans JS, Gilliam G, Heuser L, McGee G, Rao M, Scherm MJ, Voyles CR (1992) Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients. Am J Surg 163(2):221–226

    Article  CAS  PubMed  Google Scholar 

  27. Shirk GJ, Johns A, Redwine DB (2006) Complications of laparoscopic surgery: How to avoid them and how to repair them. J Minim Invasive Gynecol 13(4):352

    Article  PubMed  Google Scholar 

  28. Mintz M (1977) Risks and prophylaxis in laparoscopy: a survey of 100,000 cases. J Reprod Med 18(5):269

    CAS  PubMed  Google Scholar 

  29. Agresta F, Mazzarolo G, Bedin N (2012) Direct trocar insertion for laparoscopy. JSLS 16(2):255–259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Simforoosh N, Basiri A, Ziaee SA, Tabibi A, Nouralizadeh A, Radfar MH, Sarhangnejad R, Mirsadeghi A (2014) Major vascular injury in laparoscopic urology. JSLS 18(3):2014.00283. https://doi.org/10.4293/JSLS.2014.00283

    Article  Google Scholar 

  31. Quilici PJ, Greaney EM, Quilici J, Anderson S (1996) Transabdominal preperitoneal laparoscopic inguinal herniorrhaphy: results of 509 repairs. Am Surg 62(10):849–852

    CAS  PubMed  Google Scholar 

  32. Fernández EM, Malagón AM, Arteaga I, Díaz H, Carrillo A (2005) Conservative treatment of a huge abdominal wall hematoma after laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A 15(6):634

    Article  PubMed  Google Scholar 

  33. McDonald PT, Rich NM, Collins GJ Jr, Andersen CA, Kozloff L (1978) Vascular trauma secondary to diagnostic and therapeutic procedures: laparoscopy. Am J Surg 135(5):651

    Article  CAS  PubMed  Google Scholar 

  34. Phillips EH, Arregui M, Carroll BJ, Corbitt J, Crafton WB, Fallas MJ, Filipi C, Fitzgibbons RJ, Franklin MJ, McKernan B (1995) Incidence of complications following laparoscopic hernioplasty. Surg Endosc 9(1):16–21

    Article  CAS  PubMed  Google Scholar 

  35. Wang J et al (2013) Automatic distance measurement of abdominal aorta for ultrasonography-based visceral fat estimation. Conf Proc Ieee Eng Med Biol Soc. https://doi.org/10.1109/EMBC.2013.6611040

    Google Scholar 

  36. Levinson CJ (1974) Laparoscopy is easy—except for the complications: a review with suggestions. J Reprod Med 13(5):187–194

    CAS  PubMed  Google Scholar 

  37. Radosa JC, Meyberg-Solomayer G, Kastl C, Radosa CG, Mavrova R, Gräber S, Baum S, Radosa MP (2014) Influences of different hysterectomy techniques on patients’ postoperative sexual function and quality of life. J Sex Med 11(9):2342–2350

    Article  PubMed  Google Scholar 

  38. Harmanli OH, Tunitsky E, Esin S, Citil A, Knee A (2009) A comparison of short-term outcomes between laparoscopic supracervical and total hysterectomy. Am J Obstet Gynecol 201(5):536

    Article  PubMed  Google Scholar 

  39. Baek MH, Lee SW, Park JY, Kim D, Kim JH, Kim YM, Kim YT, Nam JH (2014) Feasibility and safety of laparoscopic surgery for obese Korean women with endometrial cancer: long-term results at a single institution. J Korean Med Sci 29(11):1536–1543

    Article  PubMed  PubMed Central  Google Scholar 

  40. Park JY, Nam JH (2014) Laparotomy conversion rate of laparoscopic radical hysterectomy for early-stage cervical cancer in a consecutive series without case selection. Ann Surg Oncol 21(9):3030–3035

    Article  PubMed  Google Scholar 

  41. Chapron C, Querleu D, Bruhat MA, Madelenat P, Fernandez H, Pierre F, Dubuisson JB (1998) Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Hum Reprod 13(4):867

    Article  CAS  PubMed  Google Scholar 

  42. Jansen FW, Kapiteyn K, Trimbos-Kemper T, Hermans J, Trimbos JB (1997) Complications of laparoscopy: a prospective multicentre observational study. Br J Obstet Gynaecol 104(5):595

    Article  CAS  PubMed  Google Scholar 

  43. Härkki-Sirén P, Kurki T (1997) A nationwide analysis of laparoscopic complications. Obstet Gynecol 89(1):108

    Article  PubMed  Google Scholar 

  44. Chapron C, Pierre F, Harchaoui Y, Lacroix S, Béguin S, Querleu D, Lansac J, Dubuisson JB (1999) Gastrointestinal injuries during gynaecological laparoscopy. Hum Reprod 14(2):333–337

    Article  CAS  PubMed  Google Scholar 

  45. Philosophe R (2003) Avoiding complications of laparoscopic surgery. Fertil Steril 80(Suppl 4):30

    Article  PubMed  Google Scholar 

  46. Soderstrom RM (1993) Bowel injury litigation after laparoscopy. J Am Assoc Gynecol Laparosc 1(1):74–77

    Article  CAS  PubMed  Google Scholar 

  47. Schwartz MJ, Faiena I, Cinman N, Kucharczyk J, Meriggi JS, Waingankar N, Richstone L, Kavoussi LR (2010) Laparoscopic bowel injury in retroperitoneal surgery: current incidence and outcomes. J Urol 184(2):589–594

    Article  PubMed  Google Scholar 

  48. Thompson BH, Wheeless CR Jr (1973) Gastrointestinal complications of laparoscopic sterilization. Obstet Gynecol 41:669

    CAS  PubMed  Google Scholar 

  49. Levy BF, De Guara J, Willson PD et al (2012) Bladder injuries in emergency/expedited laparoscopic surgery in the absence of previous surgery: a case series. Ann R Coll Surg Engl 94:e118

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Georgy FM, Fetterman HH, Chefetz MD (1974) Complication of laparoscopy: two cases of perforated urinary bladder. Am J Obstet Gynecol 120:1121

    Article  CAS  PubMed  Google Scholar 

  51. Sherer DM (1990) Inadvertent transvaginal cystotomy during laparoscopy. Int J Gynaecol Obstet 32:77

    Article  CAS  PubMed  Google Scholar 

  52. Graigner DA, Soderstrom RM, Schiff SF et al (1990) Ureteral injuries at laparoscopy: insights into diagnosis, management and prevention. Obstet Gynecol 75:839

    Google Scholar 

  53. Gomel V, James C (1991) Intraoperative management of ureteral injury during operative laparoscopy. Fertil Steril 55(2):416

    Article  CAS  PubMed  Google Scholar 

  54. Chen LF, Anderson DJ, Hartwig MG, Kaye KS, Sexton DJ (2008) Surgical site infections after laparoscopic and open cholecystectomies in community hospitals. Infect Control Hosp Epidemiol 29(1):92

    Article  PubMed  Google Scholar 

  55. Bardens D, Solomayer E, Baum S, Radosa J, Gräber S, Rody A, Juhasz-Böss I (2014) The impact of the body mass index (BMI) on laparoscopic hysterectomy for benign disease. Arch Gynecol Obstet 289(4):803–807

    Article  PubMed  Google Scholar 

  56. Voitk AJ, Tsao SG (2001) The umbilicus in laparoscopic surgery. Surg Endosc 15(8):878

    Article  CAS  PubMed  Google Scholar 

  57. Bensley RP, Schermerhorn ML, Hurks R, Sachs T, Boyd CA, O’Malley AJ, Cotterill P, Landon BE (2013) Risk of late-onset adhesions and incisional hernia repairs after surgery. J Am Coll Surg 216(6):1159–1167, 1167.e1-12

    Article  PubMed  PubMed Central  Google Scholar 

  58. Cohen MM, Duncan PG, Pope WD, Wokenstein C (1986) A surgery of 122,000 anaesthetics at one teaching hospital (1975–83). Can Anaesth Soc J 33:22–31

    Article  CAS  PubMed  Google Scholar 

  59. Winfree CJ, Kline DG (2005) Intraoperative positioning nerve injuries. Surg Neurol 63:5–18

    Article  PubMed  Google Scholar 

  60. Bauer EC, Koch N, Janni W, Bender HG, Fleisch MC (2013) Compartment syndrome after gynocologic operations: evidence from case reports and reviews. Eur J Obstet Gynecol Reprod Biol 173:7–12. https://doi.org/10.1016/j.ejogrb.2013.10.034

    Article  PubMed  Google Scholar 

  61. Radosa JC, Radosa MP, Sütterlin M (2011) Acute compartment syndrome in obstetric care. Acta Obstet Gynecol Scand 90(6):677

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str. 100, 66424, Homburg/Saar, Deutschland

    Julia C. Radosa, Katja Weiss, Lena Gabriel, Erich-Franz Solomayer &  Ingolf Juhasz-Böss

  2. Abteilung für Gynäkologie, Diakonie Krankenhaus Kassel, Kassel, Deutschland

    Marc P. Radosa

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  1. Julia C. Radosa
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  2. Katja Weiss
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  3. Lena Gabriel
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  4. Marc P. Radosa
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Correspondence to Ingolf Juhasz-Böss.

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J.C. Radosa, K. Weiss, L. Gabriel, M.P. Radosa, E.-F. Solomayer und I. Juhasz-Böss geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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T. Fehm, Düsseldorf

R. Kimmig, Essen

N. Maass, Kiel

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Radosa, J.C., Weiss, K., Gabriel, L. et al. Laparoskopische Eingriffe in der Gynäkologie. Gynäkologe 51, 343–349 (2018). https://doi.org/10.1007/s00129-018-4216-6

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