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Comparison of Complications Rates in Endoscopic Surgery Performed by a Clinical Assistant vs. An Experienced Endoscopic Surgeon.

Singhi A - J Gynecol Endosc Surg (2009)

Bottom Line: There were five significant complications in laparoscopic surgeries and four significant complications in hysteroscopic surgeries seen in four years and six months.However, the proper grooming of a novice in experienced hands, for a sufficient period of time, can minimize the complication rate in the initial learning phase.The complication may be utilized as a stepping-stone to overcome any given situation without panic, but with adequate safety.

View Article: PubMed Central - PubMed

Affiliation: Consultant, Apollo Clinic, Mumbai, Associate Consultant, National Institute of Laser & Endoscopic Surgery, Ghatkopar (East), Mumbai - 400077, India.

ABSTRACT

Study objectives: (a) To find out the actual incidence of complications during endoscopic surgeries. (b) Comparison of complication rate between an experienced laparoscopic surgeon (> 10 years of experience in endoscopic surgery) and a clinical assistant (> 3 years of experience in endoscopic surgery). (c) How to manage complications in endoscopic surgery. (d) Concrete suggestions to reduce the complication rate.

Design: Retrospective study (Canadian Task Force classification ii-2).

Setting: Tertiary gynecologic endoscopic unit.

Patients: A total of 3204 cases of gynecologic endoscopic surgery out of which 2001 were laparoscopic and 1203 were hysteroscopic surgeries.

Interventions: Laparoscopic and hysteroscopic gynecologic surgeries in indicated cases.

Measurements and main results: The study was carried out between April 2003 and October 2007 at a referral center for endoscopic surgery. A total of 3204 cases of gynecologic endoscopic surgery were studied. There were five significant complications in laparoscopic surgeries and four significant complications in hysteroscopic surgeries seen in four years and six months. All the complications could be managed with no mortality. Conversion to laparotomy was needed in eight cases of laparoscopic surgeries and none in hysteroscopic surgeries.

Conclusion: The risk of complication reduces with the experience in endoscopic surgery. However, the proper grooming of a novice in experienced hands, for a sufficient period of time, can minimize the complication rate in the initial learning phase. The complication may be utilized as a stepping-stone to overcome any given situation without panic, but with adequate safety.

No MeSH data available.


Inferior epigastric vessel injury
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Figure 3: Inferior epigastric vessel injury

Mentions: Out of two epigastric vessel injuries, one was managed with bipolar coagulation [Figures 3 and 4] and the other required intracorporeal suturing [Figures 5 and 6]. One primary trocar vessel injury was seen from 10 mm trocar site. Same could be managed with bipolar coagulation [Figures 7 and 8].


Comparison of Complications Rates in Endoscopic Surgery Performed by a Clinical Assistant vs. An Experienced Endoscopic Surgeon.

Singhi A - J Gynecol Endosc Surg (2009)

Inferior epigastric vessel injury
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3304259&req=5

Figure 3: Inferior epigastric vessel injury
Mentions: Out of two epigastric vessel injuries, one was managed with bipolar coagulation [Figures 3 and 4] and the other required intracorporeal suturing [Figures 5 and 6]. One primary trocar vessel injury was seen from 10 mm trocar site. Same could be managed with bipolar coagulation [Figures 7 and 8].

Bottom Line: There were five significant complications in laparoscopic surgeries and four significant complications in hysteroscopic surgeries seen in four years and six months.However, the proper grooming of a novice in experienced hands, for a sufficient period of time, can minimize the complication rate in the initial learning phase.The complication may be utilized as a stepping-stone to overcome any given situation without panic, but with adequate safety.

View Article: PubMed Central - PubMed

Affiliation: Consultant, Apollo Clinic, Mumbai, Associate Consultant, National Institute of Laser & Endoscopic Surgery, Ghatkopar (East), Mumbai - 400077, India.

ABSTRACT

Study objectives: (a) To find out the actual incidence of complications during endoscopic surgeries. (b) Comparison of complication rate between an experienced laparoscopic surgeon (> 10 years of experience in endoscopic surgery) and a clinical assistant (> 3 years of experience in endoscopic surgery). (c) How to manage complications in endoscopic surgery. (d) Concrete suggestions to reduce the complication rate.

Design: Retrospective study (Canadian Task Force classification ii-2).

Setting: Tertiary gynecologic endoscopic unit.

Patients: A total of 3204 cases of gynecologic endoscopic surgery out of which 2001 were laparoscopic and 1203 were hysteroscopic surgeries.

Interventions: Laparoscopic and hysteroscopic gynecologic surgeries in indicated cases.

Measurements and main results: The study was carried out between April 2003 and October 2007 at a referral center for endoscopic surgery. A total of 3204 cases of gynecologic endoscopic surgery were studied. There were five significant complications in laparoscopic surgeries and four significant complications in hysteroscopic surgeries seen in four years and six months. All the complications could be managed with no mortality. Conversion to laparotomy was needed in eight cases of laparoscopic surgeries and none in hysteroscopic surgeries.

Conclusion: The risk of complication reduces with the experience in endoscopic surgery. However, the proper grooming of a novice in experienced hands, for a sufficient period of time, can minimize the complication rate in the initial learning phase. The complication may be utilized as a stepping-stone to overcome any given situation without panic, but with adequate safety.

No MeSH data available.