Complications of Gynaecological Laparoscopy and Associated Factors at theMaternity Ward of the Gonesse General Hospital

Abstract

Background: Laparoscopic surgery in gynecology is a minimally invasive technique, which is not void of complications. Our objective was to assess the various complications which occur during gynecological laparoscopy and their associated risk factors at the Gonesse General Hospital (GGH). Method: We carried out a cross-sectional study with retrospective data collection over a two year period from August 1, 2009 to July 31, 2011, at the maternity ward of the GGH. We included all the patients operated by laparoscopy during the study period. A complication was defined as any event that affected the normal course of the procedure and resulted in a rescue action like laparotomy or close surveillance. The proportions were calculated and compared using the Chi-square test. The statistically significant threshold was set at 0.05. Results: A total of 266 women underwent gynecological laparoscopy during the study period. The mean age was 35.78 ± 12.34 years; up to 12.4% of the patients had a past history of laparotomy, while 17.3% had history of laparoscopy. Nearly half of the number of laparoscopic procedures was carried out in the context of an emergency (54.5%) and the major indications were ovarian cysts (25.2%) and ectopic pregnancies (20.3%). A total of 18 surgical complications were identified, representing 6.77% of the sample size. The complications were mostly hemorrhagic in up to 50% of the cases and laparotomy was the main recourse when the complications occurred in 66.7% of the cases. The occurrence of complications was significantly associated with major procedures, p=0.000. Conclusion: There was a high rate of complications in our study and these complications were mostly haemorrhagic in nature and associated with major procedures. The most frequent method of management of these complications was by laparotomy.